再生障碍性贫血体外实验分型与临床治疗观察

The Classification in Vitro and Observations on Clinical Treatment of Aplastic Anemia

目的：研究再生障碍性贫血（AA）在发病机制上的分型，以及临床治疗观察。方法：体外实验采用微量甲基纤维素半固体培养方法，治疗随机分组，选用雄激素或加用环胞菌素A（CSA）。结果：AA造血干细胞缺陷型、免疫介导型、微环境缺陷型在AA人群中都存在，以干细胞缺陷型偏多，传统的治疗方法（雄激素治疗）效不佳，部分合用CSA者有显效。结论：AA发病机理是不同的，CSA治疗AA值得进一步研究。

Objectives: To explore the classification in vitro by pathogenesis and to observe the clinical treatment of aplastic anemia (AA). Methods: Bone marrow mono-nucleus cells (BMMNC) were cultured in methylcellulose semisolid medium. The patients with AA, divided into different groups by random, were treated with androgen or combined androgen and cyclosporin A (CSA). Results: There were three types of BMMNC in AA patients as follows: stem cells defect, immune mediation and microenvironmental defect. Among them, the type of stem cells defect was more. The curative effect of combined androgen and CSA was better than that of androgen ( P ＜0.01). Conclusions: The pathogenesis of AA is different. The value of CSA in the treatment of AA is worth further studying.