山西省肿瘤医院/中国医学科学院肿瘤医院山西医院/山西医科大学附属肿瘤医院 药学部，山西 太原，030013
Department of Pharmacy, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, 030013, Shanxi, China
目的 探讨重组人白介素-11（rhIL-11）致肿瘤患者心力衰竭的临床特点。方法 报道某肿瘤医院收治的1例化疗后使用rhIL-11致心力衰竭患者的诊治过程，并对该病例以及检索PubMed、Embase、中国知网、万方等数据库收集到的相关病例（截至2022年4月1日）的主要临床资料（性别、年龄、疾病、rhIL-11用法用量、联合用药情况、应用rhIL-11至发生心力衰竭的时间、临床处理及转归等）进行汇总分析。结果 纳入分析的患者共7例，男性4例，女性3例；年龄29～67岁，中位年龄58岁；白血病4例，肺癌、贲门癌、髓系肉瘤各1例。7例患者rhIL-11剂量均为3 mg·d-1，有联合用药记录的3例。rhIL-11使用后发生心衰的时间为4～15 d，中位发生天数为4 d，中位累积剂量为9 mg，体液潴留发生率为57.1%（4/7），心包积液发生率为14.3%（1/7）。心衰发生时均伴有乏力、胸闷、心率加快，心功能标志物检测结果显示，NT-proBNP或BNP水平均有明显升高。停用rhIL-11并对症支持治疗后，临床表现都得到缓解、心功能标志物水平也进一步降低。结论 不同性别、不同年龄的肿瘤化疗后血小板减少症患者在使用rhIL-11时均有发生心衰的可能性，停药后及时治疗心衰，临床症状均可缓解。
Objective To explore the clinical characteristics of heart failure in the cancer patients caused by recombinant human interleukin-11(rhIL-11).Methods The diagnosis and treatment of a patient with heart failure caused by rhIL-11 in a Cancer Hospital was reported. The main clinical data (gender, age, disease, usage and dosage of rhIL-11, combined medication, time from rhIL-11 medication to onset of heart failure, clinical management and outcome, etc.) of this case and relevant cases collected from PubMed, Embase, CNKI, and Wanfang database (as of April 1, 2022) were summarized and analyzed.Results A total of 7 patients were enrolled in the study, including 4 males and 3 females, aged from 29 to 67 years with a median age of 58 years. There were 4 cases of leukemia, 1 case of lung cancer, 1 case of cardia cancer and 1 case of myeloid sarcoma. The dose of rhIL-11 was 3 mg·d-1 for all 7 patients. And 3 of them had combined medication records. The time from the application of rhIL-11 to the onset of heart failure was 4~15 days, and the median occurrence time was 4 days after rhIL-11. The median cumulative dose of rhIL-11 was 9 mg. The incidence of fluid retention and pericardial effusion was 57.1% (4/7) and 14.3% (1/7), separately. The occurrence of heart failure was accompanied by fatigue, chest tightness and accelerated heart rate. Cardiac function markers showed that the level of NT proBNP or BNP increased significantly. Clinical manifestations were improved and cardiac function markers were further reduced after withdrawing rhIL-11 and symptomatic treatment.Conclusion Tumor patients of different gender and age have the possibility of heart failure when using rhIL-11. The clinical symptoms can be alleviated by treatment of heart failure timely after rhIL-11 withdrawal.
杨静,梁素娇.重组人白介素-11致肿瘤患者心力衰竭临床特点及文献分析[J].肿瘤药学,2023,13(2):255-260 ( in Chinese)复制