老年人再生障碍性贫血28例临床分析

Clinical Analysis of 28 Aged Patients with Aplastic Anemia

目的 :探讨老年人再生障碍性贫血 (再障 )的临床特点及疗效。方法 :对同期住院的老年人及非老年人再障各 2 8例进行回顾性分析。结果 :老年患者起病前有致病因素接触者占 42 .9% ,临床上贫血、感染及出血症状多见且严重 ,并发症多 ,骨髓增生低下程度更为显著 ,对治疗反应差 ,死亡率高 ,老年再障总有效率为 35 .7% ,明显低于非老年组 6 4.3% ,P <0 .0 5。结论 :老年人再障预后欠佳 ,加强支持治疗及并发症治疗可减少病死率 ,采取更加积极的治疗措施有望提高疗效。

Objective: To study the clinical features and therapeutic response of aplastic anemia (AA) in aged patients. Methods: 28 aged and 28 non aged patients with AA hospitalized at the same period were analyzed retrospectively. Results: Exposures to causing factors were more common in eldly patients ( 42.9% ). The symptoms of anemia, infection and bleeding were more common and more severe. Complications were frequently seen. Cellularity of the bone marrow decreased significantly. Therapeutic effect was much poorer and the death rate was much higher in the aged patients. The total effective rate in aged patients ( 35.7% ) was significantly lower than that in non aged patients ( 64.3% ), P < 0.05 . Conclusions: The prognosis for aged patients with AA are much poorer. Conservative measures and managements for complications can decrease the death rate. More intensive therapy might improve the outcome.