rhG-CSF和rhIL-11联合治疗极重度骨髓型急性放射病比格狗疗效观察

Treatment of Extremely Severe Acute Hemopoietic Radiation Sickness Beagles with RhG-CSF and RhIL-11

目的观察重组人粒细胞集落刺激因子(rhG-CSF)和重组人白介素-11(rhIL-11)联合治疗极重度骨髓型急性放射病(ARS)比格狗的治疗效果,为临床救治提供依据。方法用4.5Gy^(60)Coγ射线照射比格狗建立极重度骨髓型ARS模型,随机分成照射对照组、综合对症组和细胞因子组。照射对照组不给予任何治疗,综合对症组给予包括输血、抗感染等对症治疗,细胞因子组在综合对症治疗基础上给予rhG-CSF和rhIL-11治疗3周,然后观察各组的血象变化、输血量、抗生素使用时间和动物的存活率等。结果照射后3组动物血象中各类细胞都呈急剧下降,细胞因子组治疗后血象基本恢复正常。细胞因子组的平均输血量和输血时间均显著少于综合对症组(P<0.01),抗生素使用时间也较短(P<0.05)。照后45d观察期内,存活率照射对照组为0%,综合对症组为80%,细胞因子组为100%,3组存活率有显著差异(P<0.01)。结论综合对症基础上联合rhG-CSF和rhIL-11治疗极重度骨髓型ARS比格狗,能够促进骨髓造血功能的恢复,刺激血细胞较快地回升,显著减少输血量,缩短抗生素使用时间,并能提高照射狗的存活率。

Objective To evaluate the effects of treatment combined recombinant human G-CSF（rhG-CSF）and recombinant human interleukin-11（rhIL-11）on severe acute hemopoietic radiation sickness（ARS）beagles.Methods Beagles were irradiated with 4.5 Gy ^（60）Co γ-ray to establish ARS models,and animals were divided into the irradiated control group and the supportive care and combined cytokines treatment cohort.After irradiation the irradiated control beagles was given no treatment,the supportive care beagles received purely symptomatic treatment including blood transfusion and anti-infection while the combined cytokines treatment beagles received rhG-CSF and rhIL-11 subcutaneously for three weeks besides symptomatic treatment.Results After irradiation,all kinds of cells＇ population declined sharply,but rebounded to normal basically in the combined cytokines treatment rate in the cohort.The mean blood transfusion volume of cytokines in the cohort and the period of blood transfusion all were less than those in the supportive care cohort（P0.01）.The period of administrated antibiotic of cytokines in the cohort was shorter than that in the supportive care cohort（P0.05）.In the observe period of 45 d,survival rate in the irradiated controls cohort was 0%,in the supportive care cohort was 80%,and in the combined cytokines treatment cohort was 100%（P0.01）.Conclusion Administration of rhG-CSF and rhIL-11 early after irradiation and continued daily,in combined with supportive care in severe acute hemopoietic radiation sickness beagles can improve hematopoietic function restoration,stimulate blood cells to restore to the normal level quickly,significantly decrease the reguired volume of blood transfusion,shorten the period of anti-infection and increase survival of irradiated canines.