重组人白介素-11致肿瘤患者心力衰竭临床特点及文献分析  

Clinical characteristics of heart failure caused by recombinant human interleukin-11 in cancer patients and literature case analysis

作　　者：杨静[1] 梁素娇[1] YANG Jing;LIANG Sujiao(Department of Pharmacy,Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan,030013,Shanxi,China)

机构地区：[1]山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院药学部,山西太原030013

出　　处：《肿瘤药学》2023年第2期255-260,共6页Anti-Tumor Pharmacy

摘　　要：目的探讨重组人白介素-11(rhIL-11)致肿瘤患者心力衰竭的临床特点。方法报道某肿瘤医院收治的1例化疗后使用rhIL-11致心力衰竭患者的诊治过程,并对该病例以及检索PubMed、Embase、中国知网、万方等数据库收集到的相关病例(截至2022年4月1日)的主要临床资料(性别、年龄、疾病、rhIL-11用法用量、联合用药情况、应用rhIL-11至发生心力衰竭的时间、临床处理及转归等)进行汇总分析。结果纳入分析的患者共7例,男性4例,女性3例;年龄29~67岁,中位年龄58岁;白血病4例,肺癌、贲门癌、髓系肉瘤各1例。7例患者rhIL-11剂量均为3 mg·d^(-1),有联合用药记录的3例。rhIL-11使用后发生心衰的时间为4~15 d,中位发生天数为4 d,中位累积剂量为9 mg,体液潴留发生率为57.1%(4/7),心包积液发生率为14.3%(1/7)。心衰发生时均伴有乏力、胸闷、心率加快,心功能标志物检测结果显示,NT-proBNP或BNP水平均有明显升高。停用rhIL-11并对症支持治疗后,临床表现都得到缓解、心功能标志物水平也进一步降低。结论不同性别、不同年龄的肿瘤化疗后血小板减少症患者在使用rhIL-11时均有发生心衰的可能性,停药后及时治疗心衰,临床症状均可缓解。Objective To explore the clinical characteristics of heart failure in the cancer patients caused by recombi-nant human interleukin-11(rhIL-11).Methods The diagnosis and treatment of a patient with heart failure caused by rhIL-11 in a Cancer Hospital was reported.The main clinical data(gender,age,disease,usage and dosage of rhIL-11,combined medication,time from rhIL-11 medication to onset of heart failure,clinical management and outcome,etc.)of this case and relevant cases collected from PubMed,Embase,CNKI,and Wanfang database(as of April 1,2022)were summarized and analyzed.Results A total of 7 patients were enrolled in the study,including 4 males and 3 females,aged from 29 to 67 years with a median age of 58 years.There were 4 cases of leukemia,1 case of lung cancer,1 case of cardia cancer and 1 case of myeloid sarcoma.The dose of rhIL-11 was 3 mg·d^(-1) for all 7 patients.And 3 of them had combined medication records.The time from the application of rhIL-11 to the onset of heart failure was 4~15 days,and the median occurrence time was 4 days after rhIL-11.The median cumulative dose of rhIL-11 was 9 mg.The incidence of fluid retention and pericardial effusion was 57.1%(4/7)and 14.3%(1/7),separately.The occurrence of heart failure was accompanied by fatigue,chest tightness and accelerated heart rate.Cardiac function markers showed that the level of NT proBNP or BNP increased signifi-cantly.Clinical manifestations were improved and cardiac function markers were further reduced after withdrawing rhIL-11 and symptomatic treatment.Conclusion Tumor patients of different gender and age have the possibility of heart failure when using rhIL-11.The clinical symptoms can be alleviated by treatment of heart failure timely after rhIL-11 withdrawal.

关 键 词：重组人白介素11 肿瘤化疗相关性血小板减少症 药物相关性心衰 

分 类 号：R973[医药卫生—药品] R541[医药卫生—药学]