CAJ | 학술논문

目的观察血液肿瘤化疗后血清可溶性白细胞介素-11(sIL-11)水平与血小板数量改变的关系,探索能维持血小板安全水平的sIL-11临界值,以指导临床治疗.方法收集血液肿瘤患者化疗前后的血标本,测定sIL-11和血小板水平,观察两者变化间关系并进行统计学分析.结果 99例患者完成研究.化疗后患者的sIL-11水平逐步升高,第6天达到峰值后逐渐下降;血小板数量随时间逐步降低,第10天达到最低值,然后逐渐上升;在血小板达到最低之前sIL-11已达峰值;患者化疗后sIL-11越高,血小板数量越有可能维持于较高水平.根据血小板水半最低值将病例分为两组比较,具较高血小板组有较高sIL-11峰值.其sIL-11平均增长速度快,血小板达到最低值的时间较晚,高sIL-11峰值的病例较多.多元回归显示化疗后血小板低于临界值的影响因素有:sIL-11达到最大值的日平均增长速度和化疗第4天sIL-11低于2000Pg/ml.结论血液肿瘤患者化疗后sIL-11水平与血小板数量的变化存在相关关系,可以通过测量sIL-11的变化来预测血小板数量的变化趋势.化疗第4天sIL-11<2000 Pg/ml的患者发生严重血小板减少的可能性大,建议给予rhIL-11治疗或输注血小板治疗.
목적 관찰혈액종류화료후혈청가용성백세포개소-11(sIL-11)수평여혈소판수량개변적관계,탐색능유지혈소판안전수평적sIL-11림계치,이지도림상치료.방법 수집혈액종류환자화료전후적혈표본,측정sIL-11화혈소판수평,관찰량자변화간관계병진행통계학분석.결과 99례환자완성연구.화료후환자적sIL-11수평축보승고,제6천체도봉치후축점하강;혈소판수량수시간축보강저,제10천체도최저치,연후축점상승;재혈소판체도최저지전sIL-11이체봉치;환자화료후sIL-11월고,혈소판수량월유가능유지우교고수평.근거혈소판수반최저치장병례분위량조비교,구교고혈소판조유교고sIL-11봉치.기sIL-11평균증장속도쾌,혈소판체도최저치적시간교만,고sIL-11봉치적병례교다.다원회귀현시화료후혈소판저우림계치적영향인소유:sIL-11체도최대치적일평균증장속도화화료제4천sIL-11저우2000Pg/ml.결론 혈액종류환자화료후sIL-11수평여혈소판수량적변화존재상관관계,가이통과측량sIL-11적변화래예측혈소판수량적변화추세.화료제4천sIL-11<2000 Pg/ml적환자발생엄중혈소판감소적가능성대,건의급여rhIL-11치료혹수주혈소판치료.
Objective To explore the relationship between plasma interleukin-11(sIL-11) level and platelet count post-chemotherapy with hematological malignancy patients and analyse a sIL-11 level which may maintain a safe platelet count so as to guide the treatment. Methods Blood samples were collected from the patients with hematological malignancy at certain time point of pre-and post-chemotherapy, and serum level of sIL-11 and platelet count were determined separately. Different statistical methods were applied to test the relationship between sIL-11 level and platelet changes. Results 99 cases finished this study. The findings are: the sIL-11 level went up and reached the peak on day 6 post-chemotherapy, while the platelet count kept dropping to the lowest on day 10, the sIL-11 peak occurred before the lowest platelet count, patients with faster sIL-11 increase may maintain a comparatively higher plateled count. 99 eases were grouped according to the lowest platelet count and compared: the group with higher platelet count tend to have higher peak sIL-11, more cases with higher peak sIL-11, with faster daily average sIL-11 increase, the lowest platelet count occurred later. Logistic regression analysis showed the factors contributed to lower platelet includes slower daily average sIL-11 increase and sIL-11 level less than 2000 pg/ml on Day4 post-chemotherapy. Conclusion There were correlation between the serum sIL-11 level and platelet counts, the platelet count change may be predicted by determining the plasma sIL-11 level post-chemotherapy. Patients with sIL-11 level less than 2000 pg/ml on Day4 post-chemotherapy may be endangered with severe thrombocytopenia, rhIL-11 or platelet transfusion treatment should be considered.