不同免疫抑制方案治疗儿童重型再生障碍性贫血疗效分析

Effects of ImmunosupressiveTherapy on Severe Aplastic Anemia in Children

目的探讨不同免疫抑制方案治疗儿童重型再生障碍性贫血(SAA)的疗效及毒副作用的防治。方法总结应用抗胸腺细胞球蛋白/抗淋巴细胞球蛋白、环胞菌素A和大剂量免疫球蛋白等不同免疫抑制方案,将SAA患儿随机分三组:单一免疫抑制治疗组(SIST)、联合免疫治疗组(CIST)及强化免疫治疗组(IIST),对比各方案疗效。结果SAA患儿治疗总有效率为51.69%。免疫抑制治疗方案疗效显著高于对照组(P<0.05),联用免疫治疗SAA在提高疗效和降低死亡率等方面均明显优于单药免疫抑制剂治疗(P均<0.05),但IIST组与CIST组的有效率及死亡率差异均无显著性(P均>0.05)。结论免疫抑制方案确为治疗儿童重型再生障碍性贫血的有效疗法,尤其是联用免疫治疗可能进一步提高疗效和生存率。

Objective The purpose of this study is to evaluate the therapeutic effects and side effects of immunosuppressive therapy on severe aplastic anemia（SAA） in children. Methods With statistical methoths to analyze the clinical outcomes with children SAA.These cases were given antithymocyte globulin,cyclosporin A and high dose immunoglobulin.The therapeutic effects of the regimens were evaluated and compared with each other.Results The total response rate was 51.69%.The group of immunosuppressive therapy was significantly higher than that in the control group.The therapeutic effects of combined immunosuppressive therapy on SAA was more than that of single IS therapy（P〈0.05）.No significant different between IIST and CIST group（P〉0.05）. Conclusions Immuno- suppressive therapy is effective and safe for childhood SAA,and the effect of the combined immunosuppressive therapy is better than single IS agent.In order to improve the therapeutic effects,it is necessary to make a therapeutic regimen.