重组人血小板生成素、重组人白介素11分别联合糖皮质激素治疗成人原发性免疫性血小板减少症的疗效

Efficacy analysis of recombinant human thrombopoietin or recombinant human interleukin 11 combined with glucocorticoid respectively in treatment of adult primary immune thrombocytopenia

目的探讨重组人血小板生成素(recombinant human thrombopoietin,rhTPO)、重组人白介素11(recombinant human interleukin 11,rhIL-11)分别联合糖皮质激素在成人原发性免疫性血小板减少症(primary immune thrombocytopenia,ITP)的疗效分析。方法回顾性分析2016年9月至2018年9月川北医学院附属医院收治的80例ITP患者病例资料。据用药情况分为观察组和对照组,观察组使用rhTPO联合甲泼尼龙治疗,对照组使用rhIL-11联合甲泼尼龙治疗。甲泼尼龙1 mg/(kg·d),rhTPO 15 000 IU/d,rhIL-111.5 mg/d,rhTPO、rhIL-11用药疗程均为14 d,若疗程不足14 d,血小板>100×10^9/L,停用rhTPO、rhIL-11。比较患者完全反应率(CR),达到CR的时间,治疗前后血小板水平变化,以及不良反应的发生率。结果治疗后观察组CR率与对照组CR率差异无统计学意义(P>0.05)。治疗后第9天观察组血小板水平高于对照组,差异有统计学意义(P<0.01)。治疗后第12、15天观察组与对照组血小板水平差异无统计学意义(P>0.05)。结论rhTPO联合甲泼尼龙治疗ITP患者较rhIL-11联合甲泼尼龙治疗提升血小板速度更快。

Objective To investigate the efficacy of recombinant human thrombopoietin(rhTPO)or recombinant human interleukin 11(rhIL-11)combined with glucocorticoid respectively in adult primary immune thrombocytopenia(ITP).Methods A retrospective analysis was performed to review the cases data of 80 adult patients with ITP admitted to the Affiliated Hospital of North Sichuan Medical College from September 2016 to September 2018.According to the usage of the drug,the cases was divided into the observation group and the control group.The observation group was treated with recombinant human thrombopoietin(rhTPO)combined with methylprednisolone,while the control group was treated with recombinant human interleukin-11(rhIL-11)combined with methylprednisolone.The dosage of methylprednisolone,rhTPO and rhIL-11 were 1 mg/(kg·d),15 000 IU/d,1.5 mg/d respectively.All of the groups were treated for 14 days.If the treatment period was less than 14 days,platelets of the patient were more than 100×10^9/L,the usage of rhTPO and rhIL-11 were stopped.The CR(complete response)rate,the time point that reach to CR,the platelet level before and after treatment,and the incidence of adverse reactions were recorded and compared.Results There was no significant difference in the complete response rate between the observation group and the control group after treatment(P>0.05).The platelet level of the observation group was higher than that of the control group on the 9 th day after treatment(P<0.01).There was no significant difference between the platelet levels of the two groups on the 12 th and 15 th day(P>0.05).Conclusion rhTPO combined with methylprednisolone increased platelet level in the treatment of ITP patients faster than rhIL-11 combined with methylprednisolone.