【摘要】 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-11 25μg/(kg·d)皮下注射,共7 d,PLT>100×10~9/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)、降钙索原(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。更多还原

【Abstract】 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 x 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.更多还原