ATG联合环孢素治疗35例重型再生障碍性贫血患者的疗效分析

黄丽芳; 毛汉文; 孟凡凯; 郑邈; 孙汉英

doi:10.13201/j.issn.1004-2806.2014.01.007

ATG联合环孢素治疗35例重型再生障碍性贫血患者的疗效分析

- 1 华中科技大学同济医学院附属同济医院血液内科(武汉, 430030);
- 2 武汉市第五医院血液科

详细信息

通讯作者: 孙汉英,E-mail:sunhanying@hotmail.com

中图分类号: R556.5

收稿日期: 2013-06-24

Effect of ATG combined cyclosporine treatment in 35 patients with severe aplastic anemia

- 1 Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China;
- 2 Department of Hematology, the Fifth Hospital of Wuhan

More Information

Corresponding author: SUN Hanying, E-mail: sunhanying@hotmail.com

Received Date: 24 June 2013

摘要

摘要: 目的:分析重型再生障碍性贫血(SAA)患者进行抗胸腺细胞球蛋白(ATG)联合环孢素免疫抑制治疗的疗效。方法:回顾性分析ATG联合环孢素治疗35例SAA患者的临床资料,并随访6~88个月,分析联合免疫抑制治疗的疗效及可能的影响因素。结果:使用联合免疫抑制方案治疗SAA的总体有效率为68.6%。对免疫抑制治疗有效的患者,白细胞恢复中位时间为27(12~43) d。获得治愈的8例患者,血小板恢复时间为2~6个月,其余患者血小板未能恢复,其中有7例缓解患者不依赖血小板输注。单因素分析显示,治疗前网织红细胞计数(Ret)高于24×10⁹/L的患者治疗有效率达88.9%,高于Ret<24×10⁹/L的患者(61.5%)(P<0.01);+30 d时中性粒细胞绝对值(ANC)≥1.5×10⁹/L的患者有效率为81.0%,高于ANC<1.5×10⁹/L的患者(53.8%)(P<0.05);SAA患者的有效率为81.0%,优于极重型再障患者的50.0%(P<0.05)。结论:ATG联合环孢素治疗SAA可有效减少输血依赖,治疗前患者Ret、再障的严重程度分型、+30 d的ANC可能是预测免疫抑制治疗的疗效指标。
- 贫血,再生障碍性 /
- 免疫抑制治疗 /
- 疗效分析
Abstract: Objective: To analyze the effect of the ATG combined cyclosporine (CsA) in patients with severe aplastic anemia (SAA).Method: Clinical data of 35 patients with SAA receiving ATG/CsA treatment were retrospectively analyzed.After follow-up of 6 to 88 months,the efficacy of immunosuppressive therapy (IST) and the factors that may affect the efficacy were analyzed.Result: The overall effective rate was 68.6%.In patients effective to IST,the median recovery time of white blood cell was 27 (12 to 43) days.The platelet recovery time in the 8 cured patients was 2 to 6 months,and the platelet count in the remaining patients failed to rise,of which 7 relieved cases didn't depend on platelet transfusion.The patients with reticulocte count (Ret)≥24×10⁹/L before treatment had the response rate of 88.9%,which was higher than that with Ret<24×10⁹/L (P<0.01).The patients with the neutrophils counts (ANC)≥1.5×10⁹/L at +30 day had a higher response rate of 81.0%,which was higher than that with ANC<1.5×10⁹/L (P<0.05).SAA patients' response rate (81.0%) was higher than that of the VSAA (50.0%),P<0.05.Conclusion: ATG combined with CsA can effectively reduce transfusion dependence on SAA patients.The Ret count,severity of aplastic anemia and the ANC count at +30 day may predict the efficacy of IST treatment.
- aplastic anemia /
- immunosuppressive therapy /
- effect analysis

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