术前应用重组人白细胞介素-11改善肝硬化并脾功能亢进患者血小板减少  

Preoperative application of rhIL-11 improves thrombocytopenia in patients with hepatic cirrhosis

作　　者：方和平[1] 邓美海[1] 林楠[1] 汤照峰[1] 刘波[1] 潘卫东[1] 凌云彪[1] 许瑞云[1] 

机构地区：[1]中山大学附属第三医院肝胆外科,广州510630

出　　处：《中华临床医师杂志（电子版）》2008年第12期20-24,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广东省科技计划基金资助(2004B35001007)

摘　　要：目的探讨术前应用重组人白细胞介素-11(rhIL-11)改善肝硬化并脾功能亢进患者血小板减少的疗效和安全性,以减少围术期血小板的输注。方法将乙肝肝硬化并脾功能亢进准备行脾切除术治疗的患者(n=45)分成A、B两组,A组(n=23)术前注射rhIL-1150μg·kg-1·d-1,共10d;B组(n=22)使用安慰剂。比较两组血小板计数变化、血小板输注情况、脾切除术后血小板增高发生率,肝、肾功能指标,门静脉血栓形成率,不良反应发生率。结果用药后A组血小板计数显著高于B组,A组血小板输注频率及输注量低于B组,两组比较差异有统计学意义(P<0.05);术后血小板增高发生率A组12.5%,B组16.2%,差异无统计学意义;术后各项肝酶学指标恢复均未受影响;门静脉血栓形成率A组18.6%,B组21.4%,差异无统计学意义;红眼、关节痛、局部疼痛的发生率A组高于B组,差异有统计学意义(P<0.05)。结论乙肝肝硬化并脾功能亢进患者术前应用rhIL-11可有效提高血小板计数,减少围术期血小板输注量,对术后肝功能无显著影响。Objective To investigate the efficacy and safety of preoperative application of recombinant human interleukin-11 （rhIL-11） on thrombocytopenia in hepatic cirrhosis patients with hypersplenism and reduce perioperative platelet transfusion. Methods Hepatitis B virus-related cirrhosis patients with hypersplenism （n = 45 ） ,who were ready for splenectomy,were divided into two groups：group A and group B. RhIL-11 （50 μg/kg/d） were given in group A （n = 23 ） for 10 days before operation. The platelet count changes, the effect of platelet transfusion, the incidence of platelet increase after operation, changes of heptic and renal function, formation rate of portal vein thrombosis and the incidence of adverse reactions were compared between the two groups. Results After treatment of application of rhIL-11 ,platelet count in group A was significantly higher than that in group B, while frequency and amount of platelet transfusion was lower than that in group＇B, which had significant differences （ P 〈 0.05 ） ; the incidence of platelet increase after operation of group A and B were 12.5% and 16. 2% respectively,with no statistical difference. The resumption of each liver enzyme indicator was not affected ; the formation rate of portal vein thrombosis in two groups were 21.4% and 18. 6%, respectively, without significant difference ; however, the incidence of fluid retention, red-eye, joint pain, headache in group A was higher than that of group B. Conclusions Preoperative application of rhlL-11 in hepatitis B virus-related cirrhosis patients with hypersplenism before operation can effectively increase the platelet count, reduce perioperative platelet transfusion and have no significant impact on restoration of liver function after operation.

关 键 词：白细胞介素11 肝硬化 高血压 门静脉 脾功能亢进 血小板减少 脾切 除术 

分 类 号：R657.34[医药卫生—外科学]