白介素11在血小板减少疾病中的临床应用

Clinical effect of domestic rhIL-11 on thrombocytopenia

目的观察国产重组人白介素11(rhIL-11)在治疗血小板减少疾病中的疗效.方法将55例血液肿瘤患者分为AB,BA 两组进行自身交叉对照;特发性(难治性)血小板减少性紫癜(idiopathic thrombocytopenic purpura,ITP)组入选15例;血液肿瘤患者每例均化疗2个疗程(28 d为1个疗程).A疗程化疗结束后24 h加rhIL-11,剂量为25 μg/(kg*d),皮下注射,于化疗结束后24 h开始连用14 d,B疗程化疗后不使用rhIL-11,作为空白对照;自化疗开始隔日查血常规1次,观察各疗程外周血小板计数变化.ITP患者皮下注射rhIL-11 25 μg/(kg*d),连用14 d.结果血液肿瘤组:A疗程用rhIL-11后外周血小板数均值、最高值均大于 B疗程,A、B两疗程血小板数在用药前后差异有显著意义(P<0.05).A疗程血小板数低于50×109/L 的持续天数、恢复至75×109/L以上需要天数均有不同程度缩短;ITP组:rhIL-11治疗后患者血小板数均值逐渐升高,至第15天达(99±27)×109/L,用药前后血小板数差值为(80±16)×109/L.结论 rhIL-11对难治性血小板减少性紫癜及血液肿瘤化疗导致血小板减少有一定疗效,可耐受性好.

Objective To evaluate the efficacy of recombinat human IL-11 （rhIL-11） in treatment of thrombocytopenia. Methods Fifty five patients with hematological malignancies were divided into groups AB and BA （AB meaned that cycle A should be first and cycle B second, BA meaned that cycle B should be first and cycle A second） ; 15 patients with refractory idiopathic thrombocytopenic purpura（ITP） were enrolled in the trial. Every patient received 2 cycles of same chemotherapy in patients with hematological malignancies. IL 11 was treated subcutaneously（25μg/kg/d）, beginning at 24 h after completion of chemotherapy for 14 consecutive during cycle A. Patients did not receive IL-11 during cycle B. Blood routine examination was taken every other day from the start of chemotherapy. The changes of peripheral platelet counts were observed. Results After rhIL-11 in patients with hematological malignancies, both median platelet count and median peak platelet count were increased. There was significant difference in median differential platelet count between cycle A and cycle B（ P 〈0.05） ; the days with platelet count 〈50 × 10^9/L and days for platelet recovering ≥75 × 10^9/L were shorter to a different degree. After treatment of refractory ITPwith rhIL-11, the median platelet count gradually rose to maximum of （99 ± 27） 5× 10^9/L; the median differential platelet count between before and after treatment was （80 ± 16） 5〈 10^9/L. Conclusion rhIL-11 seems to be safe and may attenuate idiopathic or chemotherapy induced thrombocytopenia. The patients are well tolerated.