激素联合重组人白细胞介素-11治疗重症原发免疫性血小板减少症的近期疗效  

Short-term therapeutic effects of hormone combined with recombinant human interleukin-11 in the treatment of severe immune thrombocytopenia

作　　者：吴玉玲[1] 汪琼[1] 余超[1] 李泓泉 Wu Yuling;Wang Qiong;Yu Chao;Li Hongquan(Blood Rheumatism and Immunology Department, Huangshan People′s Hospital, Huangshan 245000, China)

机构地区：[1]黄山市人民医院血液风湿免疫科

出　　处：《海军医学杂志》2019年第4期324-326,346,共4页Journal of Navy Medicine

摘　　要：目的研究糖皮质激素联合重组人白细胞介素-11(rhIL-11)治疗成人重症原发免疫性血小板减少症(ITP)的近期疗效和安全性.方法回顾性分析2015年2月至2018年3月黄山市人民医院收治的48例成人重症ITP患者,分糖皮质激素联合rhIL-11组(观察组)和单用糖皮质激素组(对照组),观察2组患者的年龄、性别、出血表现、前期症状、病史等,比较2组患者的有效率、完全缓解率、平均起效时间、最高血小板计数及不良反应.结果观察组和对照组出血症状均明显改善,无严重并发症,观察组总有效率是87%,对照组72%,2组比较差异无统计学意义(P=0.202).观察组完全缓解率为57%,对照组完全缓解率为28%,2者比较差异有统计学意义(P=0.045).观察组平均起效时间为(4.2±1.6)d,对照组平均起效时间为(6.3±2.7)d,2组比较差异有统计学意义(P=0.002).观察组最高血小板计数为(120.6±68.3)×10^9/L,对照组为(69.7±48.2)×10^9/L,2组比较差异有统计学意义(P=0.004).观察组中有1例治疗期间出现心律失常,经利尿对症处理后好转,后rhIL-11减量继续使用.结论激素联合rhIL-11治疗成人重症ITP能缩短起效时间,提高完全缓解率,治疗后血小板计数高,且安全性好、费用低,值得临床应用和推广.Objective To explore short-term therapeutic effects and safety of hormone combined with recombinant human interleukin-11 in the treatment of severe immune thrombocytopenia (ITP) in adult patients. Methods A retrospective analysis was made on the 48 adult patients with severe ITP, who were hospitalized in the hospital. The patients were divided into the hormone combined with rhIL-11 treatment group (or the observation group) and the simple hormone group (or the control group). Such indexes as age, gender, hemorrhage, initial symptoms and medical history were observed in the patients of the 2 groups, and then a comparison was made on the effective rate, complete remission rate, average effective onset time, peak platelet count and adverse reactions between the 2 groups.Results The symptoms of hemorrhage of both the observation and control groups all significantly improved, without any serious complications. The total effective rate in the observation group was 87% and that of the control group was 72%. No statistical significance cound be found, when comparisons were made between the 2 groups ( P =0.202). Complete remission rate of the observation group was 57%, and that of the control group was 28%. Statistical significance cound be noticed, when comparisons were made between the 2 groups ( P =0.045). The average effective onset time of the observation group was (4.2±1.6) d, and that of the control group was (6.3±2.7)d, and statistical significance cound also be noted, when comparisons were made between the 2 groups ( P =0.002). The peak platelet count of the observation group was (120.6±68.3)×10^9/L, while that of control group was (69.7±48.2)×10^9/L, also with statistical significance ( P =0.004). During the course of treatment, there was one case of arrhythmia in the observation group, but after expectant and diuretic treatment, the patient was improved, and reduced dosage of rhIL-11 was used thereafter. Conclusion Hormone combined with rhIL-11 in the treatment of severe ITP has the advantages of short ef

关 键 词：重症原发免疫性血小板减少症 糖皮质激素 白细胞介素-11 

分 类 号：R459.1[医药卫生—治疗学]