环孢菌素A与雄激素联合治疗慢性再生障碍性贫血

The combination of cyclosporin A and androgen in the treatment of chronic aplastic anemia

目的 为进一步探索环孢菌素A(CsA)联合雄激素治疗慢性再生障碍性贫血 (CAA)的疗效及有关实验指标的变化。方法 采用随机对照研究方法 ,比较单用雄激素与雄激素联合CsA治疗CAA的疗效。结果 雄激素联合CsA治疗组有效率为 87.9% ,明显高于单用雄激素对照组的 5 7.1% ;治疗组中外周血单个核细胞 (PBMNC)对正常人CFU GM免疫抑制作用阳性者有效率与阴性者比较差异有显著性 ,P <0 .0 5。结论 CsA联合雄激素治疗CAA优于单用雄激素治疗 ,PBMNC对正常人CFU GM产率的抑制试验可作为联合用药的一个指标 ,治疗有效者骨髓造血功能恢复更为完全 ,而且对部分复治者也有效。该方案不良反应小 ,患者可以耐受。

Objective To explore the therapeutic effectiveness of combination of cyclosporin A (CsA) and androgen in the treatment of chronic aplastic anemia (CAA). Method Androgen alone or combined with CsA for the treatment of CAA was compared by a randomized controlled clinical trial. Result The efficacy of androgen combined with CsA (87.9%) was higher than that of androgen alone (57.1%). Therapeutic effectiveness of the combination treatment between the patients with positive and negative peripheral blood mononuclear cells (PBMNCs) inhibiting normal colony formation unit granulocyte and macrophage (CFU GM) test showed a significant difference (P<0 005). Conclusion Androgen combined with CsA had a much better efficacy than that of androgen alone in the treatment of CAA. The patients' PBMNCs inhibiting normal CFU GM growth test can be used as an index of the treatment outcome. The side effects of the combination therapy are low and tolerable.