重组人白细胞介素11联合泼尼松治疗成年人复发性免疫性血小板减少症临床观察

Clinical observation of recombinant human interleukin - 11 combined with prednisone in the treatment of adult recurrent primary immune thrombocytopenia

目的探讨重组人白细胞介素11（rhIL-11）联合泼尼松治疗成年人复发性免疫性血小板减少症（ITP）的临床疗效和不良反应。方法回顾性分析34例成年人复发性ITP患者的临床和实验室资料，单用泼尼松方案（A组）治疗16例，予以rhIL-11联合泼尼松方案（B组）治疗18例，比较不同治疗方案的临床疗效和不良反应。结果B组有效率为44．5％，A组有效率50．O％，两组差异无统计学意义（P〉0．05）；B组治疗后7d、10d、14d血小板计数分别为（39．7±16．3）×10^9／L、（55．3±27．6）×10^9／L、（71．8±30．9）×10^9／L，A组治疗后7d、10d、14d血小板计数分别为（24．3±6．7）×10^9／L、（35．6±28．6）×10^9／L、（47．3±29．2）×10^9／L，两组差异均有统计学意义（t-=2．008、2．090、2．431，均P〈0．05）。A组有5例（31．3％）出现不良反应，B组有6例（33．3％）出现不良反应，两组不良反应发生率差异无统计学意义（χ^2=2．117，P〉0．05），但B组中有2例出现毛细血管渗漏综合征（CLS）。结论rhIL-11联合泼尼松可以促进成年人复发性ITP患者短期内血小板明显回升，有效控制出血，副反应可控。

Objective To investigate the effect and adverse reaction of recombinant human interleukin - 11 （rhIL- 11 ） combined ,with prednisone in the treatment of adults with recurrent primary immune thrombocytopenia （ITP）. Methods The clinical and laboratory data of 34 patients of adult recurrent ITP were retrospectively analyzed. 16 cases in A group were treated with prednisone, 18 cases in B group were treated with rhIL - 11 combined with prednisone. Results The effective rate of B group was 44.5 %, which of A group was 50.0%, there was no sig-nificant difference between the two groups（P 〉 0.05 ）. After 7d, 10d, 14d treatment, platelet count in B group were （39.7±16.3）×10^9/L, （55.3±27.6）×10^9/L, （71.8±30.9）×10^9/L respectively, which in A group were （24. 3 ± 6.7）×10^9/L, （35.6±28.6）×10^9/L, （47.3±29.2 ）×10^9/L respectively, the differences between the two groups were statistically significant （ t = 2.008,2. 090,2.431, all P 〈 0.05 ）. There were 5 cases （ 31.3 % ） in A group and 6 cases （33.3%） in B group showed adverse reactions, the difference between the two groups was no significant （χ^2 =2. 117 ,P 〉0.05% ）,but there were 2 cases of capillary leak syndrome（CLS） in B group. Conclusion rhIL - 11 combined with prednisone can promote significant rebound of platelet in the adult patients with recurrent IPT in a short term, effectively control bleeding, and the side effect is controllable.