CAJ | 학술논문

目的：观察重组人白细胞介素－11（rhIL－11）对脓毒症相关血小板（PLT）减少的治疗效果，探讨rhIL－11抗炎作用的机制。方法80例伴PLT减少的脓毒症患者随机分为干预组（ T组）及对照组（ C 组），两组均接受疾病所需的常规治疗，干预组加用 rhIL －1125μg／（kg· d）皮下注射，共7 d，PLT＞100×109／L时，停止给药；观察第1、3、5、7、9天两组患者外周静脉血中PLT计数，以及脂多糖（LPS）、肿瘤坏死因子－α（TNF－α）、C－反应蛋白（CRP）、降钙素原（ PCT）等炎症指标，随访入住ICU时间及28 d的病死率。结果第3天开始T组PLT计数明显高于C组，差异有统计学意义；第3～9天各观察时间点，T组PCT、LPS、TNF－α低于C组，差异有统计学意义；随访28 d内，C组病死率27．5％，T组病死率12．5％。 T组无严重不良事件发生。结论 rhIL－11能显著改善伴有PLT减少症的脓毒症患者PLT计数，能降低脓毒症患者的炎症反应，降低28 d病死率。
목적：관찰중조인백세포개소－11（rhIL－11）대농독증상관혈소판（PLT）감소적치료효과，탐토rhIL－11항염작용적궤제。방법80례반PLT감소적농독증환자수궤분위간예조（ T조）급대조조（ C 조），량조균접수질병소수적상규치료，간예조가용 rhIL －1125μg／（kg· d）피하주사，공7 d，PLT＞100×109／L시，정지급약；관찰제1、3、5、7、9천량조환자외주정맥혈중PLT계수，이급지다당（LPS）、종류배사인자－α（TNF－α）、C－반응단백（CRP）、강개소원（ PCT）등염증지표，수방입주ICU시간급28 d적병사솔。결과제3천개시T조PLT계수명현고우C조，차이유통계학의의；제3～9천각관찰시간점，T조PCT、LPS、TNF－α저우C조，차이유통계학의의；수방28 d내，C조병사솔27．5％，T조병사솔12．5％。 T조무엄중불량사건발생。결론 rhIL－11능현저개선반유PLT감소증적농독증환자PLT계수，능강저농독증환자적염증반응，강저28 d병사솔。
Objective To observe the platelet recovering and anti -inflammatory effects of recombinant human interleukin -11 ( rhIL -11 ) on the patients with sepsis who combined with thrombocytopenia , and to explore its possible mechanism . Methods Eighty patients with sepsis combined with thrombocytopenia were divided into treatment group ( rhIL-11 group) and control group (conventional therapy group ) randomly. All the patients received active antibiotics and other comprehensive treatment .rhIL-11 group were given subcutaneous injection of rhIL -11 25 μg/( kg· d) additionally for 7 days.When the platelet counts increased to 100 ×109/L, the injection was discontinued.The peripheral platelet counts were observed on the first , third, fifth, seventh, and ninth day after the treatment.Inflammatory markers (LPS, TNF-α, CRP, PCT), the length of ICU stay, and 28-day mortality were compared between two groups .Results After the third day platelet count in rhIL-11 group was significantly higher than that in control group (P<0.05);PCT, LPS and TNF-αvalues of rhIL-11 group were lower than the conventional treatment group from the third day to the ninth day.Mortality of conventional treatment group within 28 days was significantly higher than that of rhIL -11 treatment group (27.5% vs 12.5%).There were no severe adverse event in rhIL -11 group. Conclusion RhIL-11 has a protective role and can accelerate recovery of platelets , and remarkably lessen the extent of inflammatory responses , hence reducing the mortality in sepsis patients accompanied with thrombocytopenia .