糖皮质激素治疗血液疾病临床经验

Use of glucocorticoids in the treatment of hematological disorders

糖皮质激素在血液疾病中的使用非常广泛,包括自身免疫性血液疾病(如自身免疫性溶血性贫血和特发性血小板减少性紫癜等)和恶性血液疾病,其中恶性血液病主要是利用糖皮质激素溶解淋巴细胞的作用,将其作为联合化疗方案的组分之一或者单独使用,用于淋巴系统恶性肿瘤如急性淋巴细胞白血病、淋巴瘤、多发性骨髓瘤等的治疗。长期应用糖皮质激素可引起一系列不良反应,其严重程度与用药剂量及治疗时间成正比。作为血液科医生,在临床上使用糖皮质激素时应该仔细权衡利弊。

Glucocorticoids are widely used in hematological disorders,including autoimmune blood diseases, such as autoim- mune hemolytic anemia and idiopathic thrombocytopenic purpura, and malignant blood diseases. In malignant blood disea- ses, glucocorticoids are used alone or in combination with other agents, via its lymphocytolytic effects in the treatment of a- cute lymphocytic leukemia, lymphoma and multiple myeloma. Long-term use of glucocorticoids can cause a series of side effects, which are dose and time dependent. As doctors specialized in blood diseases, we should weigh the benefits and side effects of glucocorticoids.