病毒性肝炎相关性再生障碍性贫血63例临床研究

Clinical Study of 63 Cases of Aplastic Anemia Relevant to Viral Hepatitis

目的探讨病毒性肝炎相关性再生障碍性贫血的发病特点及临床疗效。方法分析再生障碍性贫血与肝炎病原学类型的关联性,測定再障病人T细胞亚群,并初步探讨与临床疗效的关系。结果63例再障中急性再障为40例,其中甲肝为20例,乙肝为20例,慢性再障为23例,均为乙肝患者,未发现丙肝,且急性再障中32例为急黄肝或亚重肝患者。測定T细胞亚群提示CD3、CD4阳性细胞百分率与正常对照无显著性差异(P>0.5),CD8阳性细胞百分率与正常对照比较亦无显著性差异(P>0.5)。经治疗23例慢性再障均好转,40例急性再障中死亡32例,好转8例。结论肝炎相关性再生障碍性贫血与肝炎病原学类型有内在的关联性,其发病机理似乎系干细胞缺陷而非细胞免疫介导,但具体机制有待进一步研究,急性再障疗效差。

Objective To study the characteristic of. causing disease and clinical curative effect of aplastic anemia relevant to viral hepatitis.Methods To analyse the ralationships between aplastic anemia and etiological type of hepatitis,examine T-cell subgroup of aplastic anemia and study preliminarily ralationships between it and clinical curative effect.Results 63 cases of aplastic anemia （AA）,acute aplastic aplastic（AAA） anemia covers 40 cases included 20 cases of hepatitis-A and 20 cases of hepatitis-B,the rest are chronic aplastic anemia （CAA） and they are hepatitis-B patients,no hepatitis-C are found.Inaddition,among patients with acute aplastic anemia,32cases are acute icterohepatitis or sub-severe hepatitis.Examination T-cell subgroup suggests： the percentages of CD3^＋ and CD4^＋ cell have no significant difference compared with the norm（P〉0.5）,and the percentages of CD8＋ have no significant difference compared with the norm too（P〉0.5）. By therapy 23 cases of CAA all turn for better, and in 40 cases of AAA ,32 cases are dead 8 cases turn for better.Conclusion AA relevant hepatitis has inherent relevance to etiological type of hepatitis,its pathogenisis seem defection on stem cell and not be mediated by cellular immunity.But,concrete mechanisms need to study further .Acute aplastic anemia＇s curative effect is bad.