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目的:研究重组人白细胞介素-11(rhIL-11)应用于ICU病房血小板减少症患者的升血小板数量和改善血小板功能的临床疗效。方法:根据临床诊断将血小板计数<70×10~9/L的60例患者按照随机数字表法分为rhIL-11组和对照组,每组30例。在常规治疗的基础上,rhIL-11组应用rhIL-11 1.5mg皮下注射,1次/d,当血小板数量升至100×10~9/L时停药;对照组注射等量生理盐水。观察2组用药前、用药后第3、5、7天血小板计数和凝血4项,以及用药前后血栓弹力图检测结果差异,并进行统计分析。结果:2组患者治疗前血小板计数差异无统计学意义,治疗后第5、7天rhIL-11组血小板计数明显高于对照组,2组差异有统计学意义。2组患者的性别、年龄、用药前后凝血4项(凝血酶原时间、活化部分凝血酶原时间、血浆凝血酶时间、纤维蛋白原)及血栓弹力图参数中的R时间、K时间、Angle角度、MA值均差异无统计学意义。rhIL-11组用药前后R、K、Angle差异无统计学意义,用药后MA较用药前增加,差异有统计学意义;rhIL-11组的有效率明显高于对照组;rhIL-11组无明显不良反应发生。结论:rhIL-11能够促进血小板减少症患者血小板数量的恢复,同时能显著改善血小板的功能,一定程度上可预防患者的出血,且疗效安全、可靠。
Objective: To investigate the clinical efficacy of recombinant human interleukin-11 (rhIL-11) in patients with ICU ward thrombocytopenia in the number of platelets and improve platelet function. Methods: According to the clinical diagnosis, 60 patients with platelet count <70 × 10 ~ 9 / L were divided into rhIL-11 group and control group according to random number table method, with 30 cases in each group. On the basis of routine treatment, rhIL-11 group was injected subcutaneously with rhIL-11 1.5mg once a day, when the number of platelets increased to 100 × 10 ~ 9 / L, the control group was injected with the same amount of saline. The difference of platelet counts and coagulation on the 3rd, 5th, 7th day after treatment were observed before and after treatment, and the difference of the results of thrombi elastography before and after treatment was statistically analyzed. Results: There was no significant difference in platelet count before treatment among the two groups. The platelet count of rhIL-11 group was significantly higher than that of the control group on the 5th and 7th day after treatment. The difference between the two groups was statistically significant. Two groups of patients, gender, age, medication before and after the clot 4 (prothrombin time, partial prothrombin time, plasma thrombin time, fibrinogen) and thrombus in the parameters of the R time, K time, Angle , MA values were no significant difference. The rhIL-11 group had no significant difference in R, K, Angle before and after treatment, and the MA was higher than before treatment, the difference was statistically significant; the effective rate of rhIL-11 group was significantly higher than that of the control group; rhIL-11 group had no obvious Adverse reactions occurred. Conclusion: rhIL-11 can promote the recovery of platelet count in patients with thrombocytopenia, and at the same time can significantly improve the function of platelets, to a certain extent, prevent bleeding in patients, and the efficacy is safe and reliable.