联合免疫抑制疗法治疗儿童难治型再生障碍性贫血疗效观察

The curative effect observation of children,refractory aplastic anemia(RAA) treated by immunosuppressive therapy(IS)

目的探讨治疗小儿难治型再生障碍性贫血(RAA)的方法并观察其疗效。方法将26例RAA按不同的治疗方法分为联合免疫抑制(IS)治疗组和常规疗法对照组,联合免疫抑制治疗组在常规疗法的基础上加用免疫抑制剂抗淋巴细胞球蛋白(ALG),观察比较两组的近、远期疗效。结果联合免疫抑制治疗组近、远期总有效率分别为100%、92.9%,常规疗法对照组近、远期总有效率分别为83.3%、75%,两组比较P<0.05;联合免疫抑制治疗组近期Hb、WBC、中性粒细胞绝对值、PLT等指标均明显好于常规疗法对照组,差异有统计学意义(P<0.05)。结论联合免疫抑制疗法可尽早地阻断免疫紊乱机制对骨髓造血功能带来的损害,进一步提高小儿RAA的近、远期疗效,减少感染和出血机会,避免复发,不仅缩短了疗程,且不良反应小,值得推广。

Objective To investigate the treatment of children with refractory aplastic anemia（RAA） method and observe its effects.Methods 26 children RAA cases were divided into IS curative group and conventional therapy group by different therapeutics,IS group in the conventional therapy based on the use of immunosuppressive agents,anti-lymphocyte globulin（ALG）.The near and long-term effects between 2 groups were observed and compared. Results The total effective rate of near and long-term effects of IS were 100% and 92.9% respectively,the total effective rate of near and long-term effects of conventional therapy group were 83.3% and 75% respectively（P〈0.05）;Hb,WBC,Neutrophilicgranulocyte,PLT of IS group were obviously better than conventional therapy group,There was a singificant difference between two groups（P〈0.05）. Conclusion IS could prevent the immune mechanism of disorders from damaging bone marrow hematopietic functions as soon as possible and could furthere enhance the near and long-term curative effects of children RAA,reduce the opportunities of infection and bleeding,and avoid the recrudescence.It shortened the period of treatment without many side effects,which was worthy to be spreaded.