摘要
目的评价国产重组人白介素-11衍生物治疗急性白血病化疗后血小板减少的临床疗效及毒副作用。方法观察我院48例急性白血病患者共96次化疗,采取平均分配、对照原则,将化疗病例分为观察组和对照组,每组AML、ALL病例数相同;所包含诱导治疗及巩固强化治疗病例数相同。观察组:于血小板计数≤75×109/L开始皮下注射rhIL-11Ala1040μg/kg,连续10~14 d;ANC<1.0×109/L同时应用GCSF 5μg(kg·d)皮下注射治疗。对照组:仅于ANC<1.0×109/L应用G-CSF 5μg(kg·d)皮下注射治疗。两组患者均于血小板计数<20×109/L输注血小板、血红蛋白<60 g/L输注红细胞。结果在第14日及21日观察组血小板计数分别为(36.7±9.4)×109/L和(97.4±16.8)×109/L,对照组分别为(24.5±8.9)×109/L和(78.3±19.1)×109/L,同一时间观察组血小板计数显著高于对照组(P均<0.05)。观察组血小板计数<20×109/L平均天数为(7.4±2.9)d,显著短于对照组的(12.7±3.4)d(P<0.05)。观察组血小板计数恢复至正常平均天数为(15.4±2.9)d,显著短于对照组的(22.7±4.3)d(P<0.05)。观察组血小板输注量低于对照组,差异有统计学意义(P<0.05)。在毒副作用方面,观察组中仅发现谷丙转氨酶轻度增高2例,尿素氮轻度增高1例,头痛3例,肌肉、关节疼痛4例,发热2例,未见其它不良反应。结论国产重组人白介素-11衍生物治疗白血病化疗后血小板减少可取得较好疗效,毒副作用轻微,具有较好的临床应用价值。
Objective To investigate the efficacy and safety of rhIL -l1Ala10 on thrombocytopenia due to chemotherapy in patients with acute leukemia. Methods 48 acute leukemia patients undergoing 96 chemotherapies were enrolled in this study. The chemotherapy cases were divided into rhIL - 11Ala10 group and control group. Patients in the rhIL - 11 （I） group received rhIL - 11 Ala10 40 ug/kg/ d for 10 -14 days once plateletss 75 ×10^9/L and G - CSF of 5 ug/kg/ d were administered subcutaneously when ANC〈 1. 0×10^9/L. Patients in the control group were only administered with G - CSF of 5 ug/kg/ d when ANC〈 1.0 ×10^9/L. Both groups were administered platelets transfusion once PLT 〈 20 ×10^9 /L and red blood cells transfusion once HGB〈 60 g/ L.Results On 14th and 21th days, the platelet counts of rhIL-11 Ala＇＂ group was（36. 7±9.4） ×10^9/L and （97. 4 ± 16. 8） ×10^9 /L which were significantly higher than that of the controlled groupe 24. 5 ± 8. 9） ×10^9 /L and（ 78. 3 ± 19. 1） ×10^9/L respectively （P 〈 O. 05） . For the rhIL - 11AlalO group, the platelet counts were less than 20 ×10^9 /L fore 7 . 4 ± 2. 9） days which was significantly shorter than that of the controlled group （12. 7 ± 3.4）days, P〈0.05）. For the rhIL-11（I） group, the platelet counts got back to normal over（15. 4 ± 2. 9） days which was shorter than the controlled group, the platelet counts of which got back to normal overf 22. 7 ± 4. 3） days. The rhIL - 11Ala10 group received significantly more PLT transfusion than the controlled groupe P 〈 0.05）. Some minor side effects including higher aminotransferase, headache, fever, joint and muscle pain were found in several cases and no other severe adverse effects were found. Conclusions The study indicated that rhIL - llAla10 is effective for combating thrombocytopenia due to chemotherapy for patients with acute leukemia accompanied with little toxicity and small side effects.
出处
《内蒙古医学杂志》
2014年第1期15-18,共4页
Inner Mongolia Medical Journal
