巨和粒对院内肺感染所致血小板减少患者血小板恢复时间的影响

Effect of Juheli on platelet recovery time in patients with thrombocytopenia induced by Hospital acquired pneumonia

目的:评价巨和粒(重组人白介素-11)对院内肺感染所致血小板减少患者血小板恢复时间的影响及其安全性。方法:选天津武警医学院附属医院神经科、普外科、内分泌科、烧伤科住院的46例院内肺感染患者为巨和粒治疗组,选择此期间在神经科、普外科、骨科、心胸外科、内分泌科、烧伤科住院的46例院内肺感染患者为对照组。2组患者均于血小板下降第1天给予经验性抗感染治疗,之后据痰培养及药敏结果给予敏感抗生素治疗14d,治疗组在血小板下降第1天同时给予巨和粒治疗,用法为50μg/Kg,皮下注射,每日1次,连用14d。对照组不予巨和粒治疗。结果:应用巨和粒治疗组血小板恢复的总有效率为93.5%,对照组总有效率为78.3%,2者相比差异有显著性(P<0.05);巨和粒组血小板恢复至>50×109/L所需时间及>100×109/L所需时间较对照组明显缩短(P<0.05);巨和粒组肺炎症状消失及胸片恢复正常所需时间较对照组缩短。应用巨和粒治疗后患者出现的不良反应有恶心、呕吐、心悸及注射皮肤局部红肿硬结等,但程度较轻,均于停药后症状消失。结论:院内肺感染所致血小板减少患者在抗感染治疗同时应用巨和粒治疗可减轻血小板下降的程度,缩短血小板减少持续时间,加速血小板数量的恢复,减少出血的风险,促进肺感染的痊愈。巨和粒的应用是安全可靠的。

Objective：To evaluate the effect and safety of Juheli（recombinant human interleukin-11,rhIL-11）on platelets recovery time in patients with thrombocytopenia induced by hospital acquired pneumonia.Method：46 cases from the department of neurology,endocrinology and burn were enrolled into Juheli treatment group,46 cases hospitalized in our department of neurology,general surgery,endocrinology,orthopedics,cardiovascular thoracic surgery and burn entered into the control group during the same time.The patients of two groups were treated with antibiotics experientially when platelets decreased.And then they were treated with sensitive antibiotics for 14 days according to sputum culture and drug sensitive tests,and 50μg Juheli per Kg was administered subcutaneously once daily in treatment group,and continuing for 14 days.Result：The total response rates of platelet recovery of treatment group and control group were 93.5% and 78.3%,respectively,which had no statistic significance（P〈0.05）.The durations of achieving a platelet count 〉50×10^9/L and〉100×10^9/L in treatment group were both shorter than those of control group（P〈0.05）.The durations of x-ray returning to normal and symptoms of pneumonia,such as cough,expectoration of abnormal sputum,fever and so on,in treatment group were both shorter than those of control group（P〈0.05）.The adverse reactions associated with Juheli included nausea,vomitting,palpitation,callosity and so on,which were mild and reversible with drug discontinuation.Conclusion：The administration of Juheli in the patients with thrombocytopenia induced by hospital acquired pneumonia could reduce thrombocytopenia rate,shorten the duration of thrombocytopenia,accelerate the recovery of platelet,decrease the risk of haemorrhage and promote recovery from pneumonia.Meanwhile,Juheli was safe and tolerated.