抗淋巴细胞球蛋白联合环孢素A治疗重型再生障碍性贫血

Anti-lymphocyte globulin combined with cyclosporine A in treatment of severe aplastic anemia

目的观察抗淋巴细胞球蛋白(ALG)和环孢素A(CsA)、雄激素联合治疗重型再生障碍性贫血(SAA)的疗效。方 法:对43例SAA患者联合使用CsA[5mg/(kg·d)剂量,服用6个月]、雄激素和ALG治疗[按15mg/(kg·d)的剂量,加入 0.9%氯化钠注射液1000ml中静滴,每日1次,每次维持10h,连用5d]。结果:治疗6个月后,患者的各项血细胞计数明显 上升(P<0.01)。基本治愈6例,缓解18例,明显进步8例,无效5例,死亡3例,转化为阵发性睡眠性血红蛋白尿2例,总有效 率74.4%。环孢素A不良反应:11例肝功能受损,6例肾功能受损,4例牙龈增生,1例多毛症;ALG不良反应:2例血清病,1 例脑出血死亡。结论:ALG联合环孢素A、雄激素治疗SAA疗效明显。

Objective:To observe the effect of anti-lymphocyte globulin(ALG)combined with cyclosporin A(CsA)in treatment of severe aplastic anemia(SAA).Methods:Forty-three patients with SAA received ALG [15mg/(kg·d)once a day for5d],CsA [5mg/(kg·d)for6months]and androgen(80mg,tid)for more than6months.Results:After6months,the blood corpuscle counts of patients increased(P<0.01).Six patients were cured,18were relieved,8were im-proved,5were ineffective,3died,2patients began to have paroxysmal nocturnal hemoglobinuria,with the overall effective rate being74.4%.Side effects of CsA:11patients had liver injury,6had kidney injury,4had gum hyperplasia,1had hairi-ness.Side effect of ALG:2had serum sickness,1died of cerebral hemorrhage.Conclusion:The outcome of ALG,CsA and an-drogen treatment for SAA is favorable. [