血小板生成素与白介素-11治疗胃癌术后辅助化疗后血小板减少症时效及安全性的比较

目的:比较血小板生成素与白介素-11治疗胃癌患者术后化疗血小板减少症的时效和安全性。方法:术后辅助化疗出现血小板计数低于75×109/L的进展期胃癌患者68例,将其分为TPO组与IL-11组,分别为35例和33例。分别皮下注射rhTPO 15000U,每日1次;rhIL-11 1.5 mg,每日1次,当血小板计数125×109/L或比用药前上升50×109/L,即停止给药,疗程最长为14天。每3天抽取外周静脉血2 m L,通过全自动血液分析仪测定血小板计数,密切观察出现的不良反应并记录。比较两组患者不同临床病理资料、血小板计数、血小板计数升至75×109/L和125×109/L的时程、药物不良反应。结果:两组患者年龄、性别、化疗方案、血小板最低值出现的化疗周期及临床病理分期的比较均没有统计学差异(P值均0.05)。TPO组与IL-11组血小板动态值的比较,第9天出现显著差异(P=0.032)。TPO组与IL-11组血小板计数恢复至75×109/L和125×109/L所需的时间,有显著差异(P=0.041,P=0.013)。TPO组中,有3例(8.6%)患者发生不良反应,IL-11组中,有13例(39.4%)患者发生不良反应,TPO组患者出现的不良反应少且较轻微(P=0.006)。结论:rhTPO治疗胃癌患者术后化疗血小板减少症时效快,安全性好。

Compared Effect and Safety of Thrombopoietin and Interleukin -11 in Treatment of Platelet Reduce of Gastric Cancer Patients after Postoperative Adjuvant Chemotherapy

Objective:To compared the effect and safety of recombinant human interleukin -11 and recombinant human thrombopoietin in treatment of gastric cancer thrombocytopenia after chemotherapy.Methods:There were 68 cases gastric cancer patients receiving postoperative adjuvant chemotherapy with their platelet counts of lower than 75× 109/L, who were divided into TPO group (35 cases) and IL-11 group (33 cases). They were given subcutaneous injection of 15000U rhTPO or 1.5 mg rhIL-11, once daily. The treatment duration was 7~14 days. In case the platelet counts surpass 125× 109/L or an absolute count increase of 50*109/L, the treatment was terminated. Otherwise, the treatment continued for 2 weeks. Platelet counts were monitored by a 3-day''s interval. The adverse reaction was carefully recorded. We compared the dynamic platelet count, the time of platelet count to 75× 109/L and 125× 109/L, and adverse effects after treatment between the 2 groups.Results:Clinicopathological data and chemotherapeutic regimens were well balanced between the 2 groups (P>0.05). The platelet counts in the 9th day of the TPO group was significantly higher than IL-11 group (P=0.032). The time of platelet counts raised to 75× 109/L and 125× 109/L was significantly faster in TPO group than IL-11 group (P=0. 041, P=0.013). We observed 3 cases (8.6%) of side reactions in TPO group and 13 cases (39.4%) in IL-11 group, which is statistically different (P=0.006).Conclusion:To treat the chemotherapy induced thrombocytopenia in gastric cancer patients receiving postoperative chemotherapy, rhTPO was a better choice for its efficiency and safety comparing to rhIL-11.