如何看待获得性再生障碍性贫血的临床分型

How to think about the clinical classifications of acquired aplastic anemia

重视获得性再生障碍性贫血(aplastic anemia,AA)的诊断分型是提高疗效的基础和正确探索病理机制的保障,具有重大临床和学术意义。目前,AA分型仍为依据临床特征进行临床分型,这是学术发展的历史产物,有益于指导对症治疗,可为治本治疗的起效赢得时间。但是,AA的临床分型不能替代病理机制分型指导治本治疗。AA的病理机制分型决定了治本策略的选择,且可为病因和预防研究提供基础,也是未来的研究方向。重视AA的病理机制分型是提高疗效的基础和正确探索病理机制的保障。现代医学已进入“分子靶点”和“精准”时代,该如何看待依据临床特征的临床分型是临床医师面临的重要问题。当AA患者中分离出的诸多不同机制的骨髓衰竭症能普遍被准确鉴别时,即临床上诊断的AA已真正纯化为一种病理机制明晰的疾病时,AA的临床分型方能有助于治本策略的选择。本文主要围绕如何看待AA的临床分型展开论述,以供同道参考。

Paying attention to the diagnosis and classification of acquired aplastic anemia(AA)is the basis for improving the efficacy and the guarantee for the correct exploration of the pathological mechanism,which is of great clinical and academic significance.At present,AA classification is still based on clinical characteristics,which is a historical product of academic development.It is beneficial to guide symptomatic treatment and for the onset of curative treatment.However,the clinical classification of AA cannot replace the pathological mechanism classification to guide the treatment of the root cause.The classification of the pathological mechanism of AA determines the choice of treatment strategy,and can provide a basis for the study of etiology and prevention,and is also the future research direction.Paying attention to the classification of the pathological mechanism of AA is the basis for improving the efficacy and the guarantee for the correct exploration of the pathological mechanism.Modern medicine has entered the era of"molecular targets"and"precision",and how to treat clinical classification based on clinical characteristics is an important issue faced by clinicians.When many different mechanisms of bone marrow failure isolated from AA patients can be accurately identified,that is,when the clinically diagnosed AA has been truly purified into a disease with a clear pathological mechanism,the clinical classification of AA can help to choose the root cause strategy.This article mainly focuses on how to view the clinical classification of AA for the reference of colleagues.