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目的:评价巨和粒(重组人白介素-11)对院内肺感染所致血小板减少患者血小板恢复时间的影响及其安全性。方法:选天津武警医学院附属医院神经科、普外科、内分泌科、烧伤科住院的46例院内肺感染患者为巨和粒治疗组,选择此期间在神经科、普外科、骨科、心胸外科、内分泌科、烧伤科住院的46例院内肺感染患者为对照组。2组患者均于血小板下降第1天给予经验性抗感染治疗,之后据痰培养及药敏结果给予敏感抗生素治疗14d,治疗组在血小板下降第1天同时给予巨和粒治疗,用法为50μg/Kg,皮下注射,每日1次,连用14d。对照组不予巨和粒治疗。结果:应用巨和粒治疗组血小板恢复的总有效率为93.5%,对照组总有效率为78.3%,2者相比差异有显著性(P<0.05);巨和粒组血小板恢复至>50×109/L所需时间及>100×109/L所需时间较对照组明显缩短(P<0.05);巨和粒组肺炎症状消失及胸片恢复正常所需时间较对照组缩短。应用巨和粒治疗后患者出现的不良反应有恶心、呕吐、心悸及注射皮肤局部红肿硬结等,但程度较轻,均于停药后症状消失。结论:院内肺感染所致血小板减少患者在抗感染治疗同时应用巨和粒治疗可减轻血小板下降的程度,缩短血小板减少持续时间,加速血小板数量的恢复,减少出血的风险,促进肺感染的痊愈。巨和粒的应用是安全可靠的。
Objective: To evaluate the effect and safety of Giant and grain (recombinant human interleukin-11) on platelet recovery time in patients with thrombocytopenia caused by nosocomial pulmonary infection. Methods: Forty-six inpatients with in-hospital lung infection were admitted to Department of Neurology, General Surgery, Endocrinology and Burn Department of Tianjin Armed Police Forces Hospital, Endocrinology, burns hospital 46 cases of nosocomial lung infection in patients with control group. Two groups of patients were given anti-infective therapy on the first day of platelet decline, then treated with sensitive antibiotics according to sputum culture and susceptibility results for 14 days. The treatment group was treated with giant and granulated tablets on the first day of platelet decline. The usage was 50μg / Kg, subcutaneous injection, 1 day, once every 14d. The control group is not giant and granular treatment. Results: The total effective rate of platelet recovery was 93.5% in the treatment group and 78.3% in the control group, the difference was significant (P <0.05) × 109 / L, and the time required for> 100 × 109 / L was significantly shorter than that of the control group (P <0.05). The time required for the symptoms of pneumonia and the normal chest radiograph to disappear in the giant and granular groups was shorter than that of the control group. Application of giant and tablets after treatment of patients with adverse reactions are nausea, vomiting, heart palpitations and injection of local inflamed skin sclerosis, etc., but to a lesser extent, were in the withdrawal symptoms disappear. CONCLUSIONS: Patients with thrombocytopenia due to nosocomial pulmonary infection can reduce the extent of thrombocytopenia while using anti-infective therapy. It can shorten the duration of thrombocytopenia, accelerate the recovery of platelet count, reduce the risk of hemorrhage and promote the recovery of lung infection. Giant and grain applications are safe and reliable.