rhTPO和rhIL-11促进老年AML患者化疗后血小板恢复的疗效比较  

Comparison of rhTPO and rh IL-11 on improving platelet recovery in elderly patients with AML after chemotherapy

作　　者：杨凯[1] 何学鹏[1] 郭智[1] 刘晓东[1] 楼金星[1] 张媛[1] 陈鹏[1] 陈惠仁[1] 

机构地区：[1]北京军区总医院血液病科,北京市100700

出　　处：《中华全科医学》2015年第10期1564-1566,1575,共4页Chinese Journal of General Practice

基　　金：国家自然科学基金(31300747)

摘　　要：目的观察应用rhTPO及rh IL-11治疗老年急性髓系白血病(AML)患者化疗所致血小板减少症的疗效及不良反应。方法将69例老年AML患者分为2组,其中36例化疗后接受rhTPO治疗,33例化疗后接受rh IL-11治疗,定期监测所有患者血常规、肝肾功能、乳酸脱氢酶、凝血功能、心肌酶谱及心电图检查。结果 rh IL-11组患者血小板由最低值恢复至≥20×109/L及≥100×109/L的时间均快于rhTPO组患者,而恢复至≥50×109/L的时间要慢于rhTPO组,2组差异无统计学意义(P值分别为0.489,0.570和0.232)。2组提升血小板疗效,rhTPO组患者显效率及有效率分别为33.3%和63.9%,较之rh IL-11组的39.4%和60.6%,差异亦无统计学意义(P=0.397)。rh IL-11组不良反应发生率36.4%较rhTPO组的13.9%增高,但差异无统计学意义(P>0.05)。结论 rhTPO及rh IL-11均能够促进老年AML患者化疗后血小板计数的恢复,有效减少血小板的输注量,降低化疗后出血相关风险。尽管rh IL-11不良反应发生率稍高,但需要进一步的临床实践研究。Objective To observe the therapeutic effects and adverse reactions of recombinant human thrombopoietin （rhTPO） and recombinant human interleukin-11 （rhIL-11 ） in the treatment of thrombocytopenia in elderly patients with acute myeloid leukemia（AML） after the chemotherapy. Methods Total 69 elderly patients with AML were divided into two groups,36 cases received rhTPO after the chemotherapy, other 33 cases received rhlL-11 therapy. Laboratory tests were performed to monitor Hemogram, liver function, renal function, lactate dehydrogenase, coagulation function, myocardi- al enzymes and electrocardiogram. Results Median time of platelet recovered to 20 x 109/L and 100 x 109/L in the rhIL- 11 group were faster than in the rhTPO group, but to 50 x 109/L was slower as compared with the rhTPO group, there was no statistical differences between the rhIL-11 group and the rhTPO group （P = 0. 489 , 0. 570 and 0. 232）. On improving platelet recovery,the markedly effective rate and effective rate in the rhTPO group was 33.3% and 63.9% ,in the rhIL-11 groups were 39.4% and 60.6%, there was no significant differences （P = 0.397 ）. Although the adverse reactions occur- ring in the rhIL-11 group was 36.4% ,higher than the rhTPO group（ 13.9% ） ,there was no statistical differences between two groups（P 〉 0.05 ）. Conclusion Both rhTPO and rhlL-11 can promote platelet recovery in elderly patients with AML after the chemotherapy, and effectively reduce the number of unites platelets transfused, and reduce the risk of bleeding. Although the adverse reactions of rhIL-11 is a little higher, but the further clinical practice are needed.

关 键 词：重组人血小板生成素 重组人白介素-11 急性髓系白血病 疗效 

分 类 号：R733.71[医药卫生—肿瘤] R730.53[医药卫生—临床医学]