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Objective To analyze the arrhythmia after treatment with recombinant human interleukin 11 (rhIL-11) because of down-regulating platelet in elderly patients with myelodysplastic syndromes (MDS), and to investigate the possible mechanism of arrhythmia induced by in MDS patients. Methods The data of 2 MDS patients with arrhythmia after rhIL-11 therapy were analyzed retrospectively. The patients'hemoglobin, electrocardiogram (ECG), myocardial enzymes, cardiac troponin Ⅰ (cTnⅠ), N-terminal pro brain natriuretic peptide (NT-proBNP) changes, as well as cardiac ultrasonography and Holter monitoring during arrhythmia were dynamically observed before and after use of rhIL-11, at the time of arrhythmia and restoring sinus rhythm after the withdrawal of rhIL-11. Results Before the use of rhIL-11, blood platelet count of patient 1 and patient 2 was 2×109/L and 3×109/L respectively. Arrhythmias occurred in the two patients at 11st and 14th days respectively. ECG showed atrial fibrillation with rapid ventricular rate, and dynamic ECG monitoring showed that syncope was caused by sinus arrest due to cardiac cardiogenic syncope. Heart ultrasound prompted ejection fraction (EF) values in the normal range. Creatine kinase, creatine kinase isoenzymes, aspartate transaminase, lactate dehydrogenase, and cTnⅠ had no obvious increase or decrease after rhIL-11 treatment, but NT-proBNP was increased significantly. After discontinuation of rhIL-11 and diuretic treatment, no syncope occurred. ECG restored sinus rhythm, and NT-proBNP was decreased significantly. Conclusion rhIL-11 in elderly MDS patients may induce arrhythmia, which can be restored after drug withdrawal, limited sodium diet and diuretic treatment, but much attention should be paid to the heart-related symptoms and signs, dynamic monitoring of NT-proBNP and timely treatment.
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Objective To investigate the effect of pemetrexed on the immune function,quality of life and survival time of patients with malignant pleural effusion.Methods Eighty cases patients with non-small cell lung cancer from July 2013 to October 2015 in the People′s Hospital of Hunan Province were complicated with pleural effusion,and randomly divided into observation group and control group,40 cases in each group.The control group were used chemotherapy with GP(gemcitabine plus cisplatin) and the central venous catheter was placed in the thoracic cavity.The observation group was treated with retrograde injection of pemetrexed catheter on the basis of the control group.The changes of immunoglobulin and inflammatory cytokines were compared between the two groups,and the quality of life and the 1 year survival rate of the two groups were statistically analyzed.Results The IgM,IgG and IgA of the observation group after the intervention were higher than those in control group((1.65±0.03) mg/L vs.(1.31±0.02) mg/L,(9.55±0.12) mg/L vs.(8.82±0.10) mg/L,(3.99±0.20) mg/L vs.(1.81±0.13) mg/L,t=59.640,29.557,57.800,P<0.05),the TNFα-,IL-1,hs-CRP levels of the observation group after the intervention were lower than the control group((12.0±0.2) μg/L vs.(18.1±0.5) μg/L,(0.60±0.1) mg/L vs.(0.92±0.2) mg/L,(10.3±1.0) mg/L vs.(31.3±2.0) mg/L,t=71.641,9.051,59.397,P<0.05),and quality of life score after the intervention than before((81.5±2.3) points vs.(81.6±2.3) points,(35.3±1.1) points vs.(56.6±1.7) points,t=114.608,55.823,P<0.05).Quality of life of the observation group was better than the control group(t=66.530,P<0.01),1 year survival rate was higher than the control group(25.0%(10/40) vs.50.0%(20/40),U=5.903,P<0.05).Conclusion Local chemotherapy with pemetrexed could significantly improve the immune function of patients with malignant pleural effusion,reduce the inflammatory response,improve the quality of life and prolong the survival time of patients with malignant pleural effusion.