抗胸腺细胞球蛋白治疗再生障碍性贫血的疗效分析

ANALYSIS OF THE THERAPUTIC EFFECTSOF ANTITHYMOCYTE GLOBULIN IN THETREATMENT OF CHILDHOOD APLASTICANEMIA

应用抗胸腺细胞球蛋白（ＡＴＧ）治疗儿童再生障碍性贫血（简称再障）３０例。其中急性再障（ＳＡＡ－Ｉ）１０例，慢性重型再障（ＳＡＡ－ＩＩ）１１例，普通慢性再障（ＣＡＡ）９例。总有效率为５６．７％。３０例中有重型丙障（ＳＡＡ－Ｉ及ＳＡＡ－ＩＩ）共２１例，其中６例缓解，７例明显进步，总有效率为６１．９％。重型再障长期生存率为６８．４％。再障患儿治疗前有关临床资料与ＡＴＧ疗效关系分析提示，疗前外周血网织红细胞绝对计数＞１０×１０￣９／Ｌ及病程较短（＜６个月）者有效率高（Ｐ＜０．０５）。ＡＴＧ疗效与其他因素，如年龄、性别、免疫状态及疗前外周血粒细胞和血小板计数的高低无关。上述资料可以作为儿童再障应用ＡＴＧ治疗的病例选择及疗效预测参考指标。

AbstractThirty children with aplastic anemia(A)(10severe acute AA(SAA-I),11 severe chfonic AA(SAA-II)and 9 less severe chronic AA(CAA)cases)were treated with antithymocyte globulin(ATG).Theoverall response rate was 56.7%(16/30). The re-sponse rate among the 21 cases of SAA(SAA-I andSAA-II) was 61.9%(13 / 21),6 cases achieved com-plete remission and 7 got significant hematopoieticimprovement.The analysis of prognostic factors sug-gested that the absolute reticulocvte counts > 10×10￣9/L in initial blood counts and disease duration<6 months before ATG therapy were associated withbetter clinical response, and the response was not cor-related with the patient's age,sex, peripheralgranulocyte and platelet counts and immunologicalstatus. The findings ofthis study may be of some valuein selection of cases for ATG treatment of childboodAA and in prediction of prognosis.