IL-11治疗慢性特发性血小板减少性紫癜的疗效观察.docVIP

IL-11治疗慢性特发性血小板减少性紫癜的疗效观察 作者：张秋荣，吴德沛，陈令松，曹若男 【摘要】 为了探讨慢性特发性血小板减少性紫癜（CITP）患者血清IL-11水平的动态变化及意义， 研究 重组人白细胞介素-11(rhIL-11) 对CITP的 治疗 作用，采用ELISA 方法 对CITP患者治疗前后血清IL-11含量进行动态测定，并将rhIL-11 应用 于CITP患者，剂量1.5 mg，皮下注射，每天1次，1疗程14天，治疗1-2疗程。结果表明： CITP患者血清IL-11水平明显高于正常对照组，且血清IL-11水平与CITP患者血小板数呈平行性升高；患者经2个疗程rhIL- 11治疗后，血小板数均有不同程度的升高。结论： CITP患者血清IL-11水平与患者的血小板数有一定的相关性，且rhIL-11对CITP有较好的治疗效果。 【关键词】 血小板 　　Curative Effect of Interleukin 11 on Chronic Idiopathic Thro-mbocytopenic Purpura 　　Abstract The aim of this study was to investigate the circulating levels of IL-11 in the patients with chronic idiopathic thrombocytopenic purpura (CITP)，and its significance，and to evaluate the curative effect of rhIL-11 on CITP. The level of IL-11 in patients with CITP was determined by ELISA before and after treatment，respectively. 1.5 mg of rhIL-11 were injected subcutaneously，once a day，continuously for 14 days as one course，treatment time 1-2 courses as total. The results showed that the higher blood IL-11 level was found in CITP patients than that in controls (P0.01) and during the course of treatment the number of platelets in peripheral blood of patients with CITP paralled to the level of IL-11. The platelet counts were obviously increased in all CITP patients after rhIL-11 treatment. It is concluded that the serum level of IL-11 in patients is correlated to the number of platelets in patients. rhIL-11 can be used as an effective treatment for CITP. 　　Key words IL-11；chronic idiopathic thrombocytopenic purpura；platelet 慢性特发性血小板减少性紫癜(CITP)为血液系统常见病， 目前 治疗以糖皮质激素为首选。但这种治疗需要长期进行且有毒副作用，而相当部分病例会反复发作。有关IL-11治疗CITP 的研究报道较少，为此我们检测了29例CITP患者共66份血清的IL-11水平，并使用rhIL-11治疗22例CITP患者，取得了较满意疗效，现报道如下。 　　材料和方法 　　病历资料 　　选择29例CITP患者，诊断符合张之南主编的《血液病诊断及疗效标准》［1］，其中男11例，女18例，年龄13-65岁，中位年龄36岁，平均年龄31.4岁，血小板相关抗体pAIgG值均升高，免疫球蛋白IgG降低14例，IgA降低7例，IgM降低4例；T细胞亚群CD4+降低16例，CD4+/CD8+降低13例。采用糖皮质激素为主的常规疗法，抽取治疗前(n=29)和治疗后血小板回升至100×109/L患者 (n=21) 及6个月后血小板仍100×109/L的患者(n=16)外周血5 ml，测血小板数，并收集血清共66份，置-80℃冰箱备检。正常对照者20名，为健康志愿者及献血员。另选经反复糖皮质