重组人血小板生成素对化疗后血小板减少症患者白细胞计数和炎性因子的影响

Effects of recombinant human thrombopoietin on leukocyte count and inflammatory cytokines in patients with thrombocytopenia after chemotherapy

目的:探讨重组人血小板生成素(Recombinant human thrombopoietin,rhTPO)治疗急性白血病化疗后血小板减少症的效果以及对白细胞计数和炎性因子的水平的影响。方法:选择我院2016年1月至2018年6月收治的113例急性白血病化疗后血小板减少症患者为研究对象,按照随机对照原则分为对照组(51例)和研究组(52例),分别给予皮下注射重组白细胞介素-11(Recombinant interleukin-11,rhIL^-11)(15000 U·d^-1,连续用药7~14 d)和rhTPO(1.5 mg·d^-1,连续用药7~14 d)治疗,比较两组患者入院时和治疗2 d、7 d、14 d时空腹静脉血白细胞计数以及炎性因子,如白细胞介素-4(Interleukin-4,IL-4)和白细胞介素-8(Interleukin-8,IL-8)的变化情况。结果:研究组患者治疗7 d和14 d时血小板计数明显高于对照组(P<0.05);血小板计数水平<50×109·L^-1持续时间,恢复至>70×109·L^-1所需时间和恢复至>100×109·L^-1所需时间均短于对照组(P<0.05);治疗7 d和14 d时IL-4和IL-8水平显著低于对照组(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:rhTPO治疗急性白血病化疗后血小板减少症效果明显,有助于及时恢复患者白细胞计数,降低机体炎性因子水平。

Objective:To investigate the effects of recombinant human thrombopoietin(rhTPO)on thrombocytopenia in acute leukemia patients after chemotherapy.Methods:All together 113 patients with thrombocytopenia after chemotherapy of acute leukemia admitted to our hospital from January 2016 to June 2018 was enrolled.All of the patients were randomly divided into the control group(51 cases)and the research group(52 cases).They were treated with recombinant interleukin-11(rhIL^-11,15000U·d^-1 for 7~14 days)and recombinant human thrombopoietin(rhTPO,1.5mg·d^-1 for 7~14 days),respectively.The changes of interleukin count and inflammatory cytokines at admission and 2,7 and 14 days after treatmentwere compared between the two groups.Results:The platelet count in the research group was higher than that of the control group on the 7th and 14th day of treatment(P<0.05).The duration of platelet count<50×109·L^-1,the time to recover to>70×109·L^-1,and the time to recover to>100×109·L^-1 were shorter than those of the control group(P<0.05).The levels of IL-4 and IL-8 in the research group were significantly lower than those in the control group on the 7th and 14th day of treatment(P<0.05).There were no significant differences in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:rhTPO is effective in the treatment of thrombocytopenia after acute leukemia chemotherapy,which is helpful to restore the white blood cell count in time and reduce the amount of inflammatory cytokines.