Objective: To analyze and compare the efficacy of recombinant human thrombopoietin (rhTPO) and recombinant human interleukin-11 (rhIL-11) in the treatment of thrombocytopenia after chemotherapy in acute leukemia patients.
Methods: 180 patients with acute leukemia complicated with thrombocytopenia after chemotherapy in the First Affiliated Hospital of Anhui Medical University were analyzed retrospectively. Among them, 50 patients who treated with rhTPO and did not receive platelet transfusion were set as group A, 50 patients treated with rhTPO and receive platelet transfusion were set as group B, Forty patients treated with rhIL-11 without platelet transfusion were set as group C, Forty patients who treated with rhIL-11 and received platelet transfusion were set as group D. The duration of PLT below 20×109/L, the days it takes for PLT to recover to more than 100×109/L, and the incidence of different bleeding degrees were compared among several groups.
Results: The duration of PLT<20×109/L in group A(3.72±1.14 d) was significantly shorter than that in group C(4.93±1.33 d) (P<0.001), and there was no significant difference from group B (P>0.05). The duration of PLT<20×109/L in group B(3.06±0.91 d) was significantly shorter than that in group D(4.65±0.98 d) (P<0.001), while the difference in duration of days between group C and D was not statistically significant (P>0.05). The times for PLT to recover to 100×109/L in group A(13.46±1.67 d) were significantly shorter than that in group C(16.85±2.13 d) (P<0.05), but there was no significant difference from group B (P>0.05). The time required for PLT to recover to 100×109/L in group B(13.36±1.49 d) were significantly shorter than that in group D(16.18±1.78 d) (P<0.05), while the difference in the days required for group C and group D was not statistically significant (P>0.05). The incidence of high bleeding risk in group B was significantly lower than that in group A (22% vs 44%, P<0.05), the incidence of high bleeding risk in group D was significantly lower than that in group C (32% vs 65%, P<0.05), and the incidence of high bleeding risk in group A was significantly lower than that in group C (44% vs 65%, P<0.05). The incidence of high bleeding risk in group B(22%) was lower than that in group D(32.5%), and the difference was not statistically significant (P>0.05).
Conclusion: In the treatment of acute leukemia patients with thrombocytopenia after chemotherapy, compared with rhIL-11, rhTPO can significantly shorten the duration for patients in a status with extremely low levels of PLT and the recovery time of PLT to normal range. In addition, PLT transfusion cannot speed up the time for patients to raise platelets to a safe range, nor can it shorten the duration of low PLT levels, but it can reduce the incidence of high bleeding risk events.
题目: rhTPO与rhIL-11对白血病化疗后血小板减少的疗效分析.
目的: 分析比较重组人血小板生成素（rhTPO）与重组人白介素-11（rhIL-11）在急性白血病化疗后血小板(PLT)减少患者治疗中的效果.
方法: 回顾分析安徽医科大学第一附属医院180例急性白血病化疗后并发血小板减少症患者，其中50例使用rhTPO治疗且未进行血小板输注的为A组，50例使用rhTPO治疗且进行血小板输注的为B组，40例使用rhIL-11治疗且未进行血小板输注的为C组，40例使用rhIL-11治疗且进行血小板输注的为D组, 比较各组患者PLT 在 20×109/L 以下持续天数、PLT恢复至大于100×109 /L 所需天数以及不同出血程度的发生率.
结果: A组PLT＜20×109/L水平持续时间显著短于C组（3.72±1.14 d vs 4.93±1.33 d， P＜0.001），与B组差异无统计学意义（P＞0.005）。B组PLT＜20×109/L水平持续的天数显著短于D组（3.06±0.91 d vs 4.65±0.98 d，P＜0.001），而C组和D组持续的天数差异无统计学意义（P＞0.05）。A组PLT恢复至100×109/L的时间显著短于C组（13.46±1.67 d vs 16.85±2.13 d， P＜0.05），而与B组差异无统计学意义（P＞0.05）；B组PLT恢复至100×109/L的天数显著短于D组（13.36±1.49 d vs 16.18±1.78 d， P＜0.001），而C组和D组所需天数差异无统计学意义（P＞0.05）。B组的高出血风险发生率明显低于A组（22% vs 44%， P＜0.05），D组的高出血风险发生率明显低于C组（32% vs 65%， P＜0.05），A组的高出血风险发生率明显低于C组（44% vs 65%， P＜0.05）, B组的高出血风险发生率低于D组(22% vs 32.5%），差异无统计学意义（P＞0.05）.
结论: 在急性白血病化疗后血小板减少患者的治疗中，与rhIL-11比较，rhTPO能明显缩短患者血小板处于极低水平状态及升至正常的时间，而血小板的输注不能加快患者血小板升高至安全范围的时间，也不能缩短患者处在低血小板水平持续的时间，但可以减少患者高出血风险事件的发生率.
Keywords: acute leukemia; chemotherapy; recombinant human interleukin-11; recombinant human thrombopoietin; thrombocytopenia.