重组人血小板生成素与白介素-11治疗急性髓系白血病化疗后血小板减少症的疗效分析  

Efficacy of Recombinant Human Thrombopoietin and Recombinant Human Interleukin 11 for Treatment of Chemotherapy Induced Thrombocytopenia in Acute Myeloid Leukaemia Patients

作　　者：唐广[1] 王晓敏 孟君霞[1] 栾春来[1] 陈杰甫[1] 武永强[1] 张晓南[1] 何孜岩[1] 

机构地区：[1]河南省安阳地区医院血液科 [2]河南省安阳肿瘤医院放疗科,河南安阳455000

出　　处：《中国实验血液学杂志》2018年第1期234-238,共5页Journal of Experimental Hematology

摘　　要：目的:评价重组人血小板生成素与白介素-11治疗成人急性髓系白血病化疗后血小板减少症的临床疗效和安全性。方法:将96例骨髓完全缓解的成人急性髓系白血病患者应用随机对照方法分为治疗组和对照组;治疗组又分为rhTPO组和rhIL-11组,对照组为不应用升血小板药物患者,每组患者各32例,各组均采用标准联合化疗药物。rhTPO和rhIL-11组在化疗结束后24 h内分别应用rhTPO 15000 IU/d和rhIL-11 1.5 mg/d,当血小板升至100×10~9/L以上时停用药物,最多用14 d。观察血小板<50×10~9/L持续时间和血小板恢复至≥50×10~9/L、≥100×10~9/L所需时间,记录各组输注单采血小板份数,并观察不良反应。结果:rhTPO组血小板<50×10~9/L持续天数明显少于对照组(P<0.01),rhIL-11组时间虽少于对照组,但无统计学意义(P>0.05)。rhTPO组血小板<50×10~9/L持续天数少于rhIL-11组,但无统计学意义(P>0.05)。与对照组比较,rhTPO和rhIL-11组均可较快将血小板数提升至≥50×10~9/L(P<0.01,P<0.05),rhTPO组血小板数提升速度虽快于rhIL-11组,但无统计学意义(P>0.05)。与对照组比较,rhTPO组及rhIL-11组均可较快地将血小板数提升至≥100×10~9/L(P值均<0.01),rhTPO组明显快于rhIL-11组(P<0.05)。rhTPO和rhIL-11组输注血小板数均明显少于对照组(P<0.01,P<0.05),且rhTPO组输注数低于rhIL-11组(P<0.05)。应用rhTPO和rhIL-11后个别患者发生低热、注射部位有硬结、关节酸痛、恶心、呕吐等不良反应(发生率分别为18.7%、31.2%)(P>0.05),但其程度均较轻,患者均可耐受。结论:rhTPO和rhl L-11均可缩短成人急性髓系白血病化疗后血小板减少持续时间,缩短血小板恢复至正常需要时间及减少单采血小板输注数目,降低化疗后出血风险,且不良反应发生率低,程度轻,患者均可耐受。两种药物比较,rhTPO更具优势,值得临床推广应用。Objective： To evaluate and compare the clinical efficacy and safety of recombinant human thrombopoietin（ rhTPO） and recombinant human interleukin11（ rhIL-11） for the treatment of chemotherapy-induced thrombocytopenia in adult acute myeloid leukaemia patients. Methods： Total of 96 adult acute myeloid leukaemia patients were divided into 3 groups according to randomized controlled method： rhTPO group,rhIL-11 group and control group,32 cases in each group. The patients in rhTPO group and rhIL-11 received rhTPO of 15000 IU/d and rhIL-11 of 1. 5 mg/d,respectively after the standard combined chemotherapy within 24 hours,and patients in control group,received nothing drugs to promote thrombocyte recovery. And rhTPO and rhIL-11 should be stopped when the Plt≥100 × 10^9/L. After chemotherapy,the platelet recovery degree,duration of Plt 50 × 10^9/L,≥50 × 10^9/L and≥100 × 10^9/L,the count of infusion thrombocytes,and incidence of adverse reactions all were compared. Results： The duration of Plt 50 × 10^9/L was obviously less than that in control group（ P〈0. 01）. The duration of rhIL-11 was less than that in control group,but there was no statistical significance（ P〉0. 05）. As compared with that in control group,the Plt count in rhTPO and rhIL-11 groups can faster increase to Plt≥50 × 10^9/L（ P〈0. 01,P〈0. 05）,among them the Plt count in rhTPO group faster increase,but there was no statistical signiticance. As compared with that in control group,the Plt count in rhTPO group and rhIL-11 group can increase to Plt ≥ 100 × 10^9/L（ P〈0. 01）,the Plt count in rhTPO group was more obviously increase than that in rhIL-11 group（ P〈0. 05）. The count of infusion Plt in rhTPO and rhIL-11 groups was lese than that in control group（ P〈0. 01,P〈0. 05）,and the count of infusion Plt in rhTPO group was less than that in rhIL-11 group（ P〈0. 05）. After using rhTPO and rhIL-11,the adverse reactions,such as lowfever,induration of injection site,athralgia,nausea and vomiti

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 血小板减少症 疗效分析 

分 类 号：R733.71[医药卫生—肿瘤] R558.2[医药卫生—临床医学]