重组人血小板生成素与重组人白介素-11治疗脓毒性血小板减少症临床疗效比较

摘要

Objective: To evaluation the clinical effect of recombinant human thrombopoietin (rhTPO) and interleukin -11 (rhIL-11) in the treatment of sepsis-related thrombocytopenia. Methods: According to the principle of minimum distribution imbalance index, 76 patients with sepsis-associated thrombocytopenia were randomly divided into the control group, rhTPO group and the rhIL-11 group. All the patients received active antibiotics and other comprehensive treatment. The rhTPO group:rhTPO was given 300 U/(kg·d);rhIL-11 group: rhIL-11 was given 1.5 mg/(kg·d). When platelet count increased to 100×109/L or platelet absolute value frequency increased 50 ×109/L , the injection was discontinued. Results : After 1, 2 day platelet count rise was not apparent and significant in there groups; The third day platelet count in rhTPO group was significantly higher than that in rhIL-11 group and control group (P<0.05); The time needed by > 50xl09/L and ≥100x109/L and platelet transfusion volume were decreased in rhTPO group than those in rhIL-11 group and control group(P< 0.05); rhTPO group of adverse reactions were significantly lower that in than rhIL-11 group. There were no statistical differences in the day of ICU;In rhTPO group and rhIL-11 group 28-day mortality were significantly lower than that in control group ,but there were no statistical differences in rhTPO group and rhIL-11 group. Conclusion: rhTPO can significantly increase platelet count ,and decrease the amount of blood transfused. The administration of rhTPO is safer and more efficient than rhIL -11 for the treatment of sepsis-associated thrombocy-topenia.%目的:评价重组人血小板生成素(rhTPO)与重组人白介素-11(rhIL-11)治疗脓毒症相关性血小板减少症患者的临床疗效.方法:将76例脓毒症合并血小板减少的患者,根据“不平衡指数最小的分配原则”随机分为对照组,rhTPO组与rhIL-11组.3组均在控制感染等综合治疗的基础上,rhTPO组予以rhTPO 300 U/(kg·d),rhIL-11组予以rhIL-11 1.5 mg/(kg·d).当血小板计数恢复至100×109/L或血小板绝对值升高≥50×109/L时即停药.结果:给药第1、2天,3组血小板计数升高不明显,用药第3天血小板计数rhTPO组显著高于rhIL-11组和对照组(P＜0.05)；rhTPO组血小板计数恢复到＞50×109/L及≥100×109/L所需时间及输注血制品量均少于rhIL-11组和对照组(P＜0.05)；rhTPO组不良反应率显著低于rhIL-11组(P＜0.05).随访28 d内病死率rhT-PO组和rhIL-11组显著低于对照组,但rhTPO组和rhIL-11组间无统计学差异(P＞0.05).结论:rhTPO在促进脓毒症相关血小板减少症血小板数的恢复,减少患者血制品输注量,安全性较rhIL-11更可靠.