重组人白介素-11治疗肿瘤患者化疗所致血小板减少的临床观察

Clinical analysis of recombinant human interleukin-11 in treatment of chemotherapy-induced thrombocytopenia in patients with malignant tumors

为了评价重组人白介素-11（rhIL-11）治疗肿瘤患者化疗所致血小板减少的疗效和安全性,回顾性分析化疗后出现≤Ⅱ度血小板减少应用rhIL-11治疗的73例患者临床资料。化疗后血小板〈75×10^9L^-1应用rhIL-11治疗的73例恶性肿瘤患者,治疗持续时间为4-23 d（7.4±4.2）,治疗有效率为93.2%,其中50例血小板〈50×10^9L^-1的患者中,治疗有效率为92.0%;血小板Ⅱ度（23例）和Ⅲ/Ⅳ度（50例）患者,应用rhIL-11治疗时的PLT数值分别为（62.8±6.1）×109和（39.8±18.6）×10^9L^-1,治疗持续时间分别为4-9 d（5.0±1.4）和4-23 d（8.5±4.6）,差异有统计学意义,P〈0.05;rhIL-11开始治疗时血小板数值与疗效和用药时间均呈负相关,P均〈0.05。不良反应为水肿、心悸、胸闷不适、肌肉关节疼痛、乏力、低热、结膜充血和心律失常（频发房性早博）。初步研究结果提示,rhIL-11治疗肿瘤患者化疗后血小板减少安全有效,早期应用能起到更佳的效果。

The objective of this study was to evaluate the efficacy and safety of recombinant human interleukin- 11 in the treatment of thrombocytopenia caused by chemotherapy in patients with malignant tumors. The clinical data of 73 patients were analyzed retrospectively. The patients were given recombinant human interleukin-11 （rhIL-11） when their platelet count was 〈75 ×10^9 L^-1. The effective rate in the totle patients was 93.2% with the treatment duration of 4--23 （7.4±4.2） days. The effective rate in the 50 patients whose platelet count was 〈50×10^9 L^-1 was 92.0%. The patients who had grade Ⅱ thrombocytopenia were given rhlL-11 for 4--9 （5.0±1.4） days, and their platelet count was （62.8±6.1） × 10^9 L^-1 when rhIL-11 was given. The patients who had grade Ⅲ/Ⅳ thrombocyto- penia were given rhIL-11 for 4--23 （8.5±4.6） days, and their platelet count was （39.8±18.6）×10^9L^-1. These differences were significant （P〈0.05）. The count of platelets when rhIL-11 was administrated was negatively related with the efficacy and the treatment duration （P（0.05）. The side effects included edema, heart-throb, chest discomfort, muscle and joint pain, fatigue and slight fever, etc. In conclusion, rhlL-11 is effective and safe in the treatment of thrombocytopenia caused by chemotherapy in patients with malignant tumors. The efficacy will be better if it is given earlier.