抗胸腺细胞球蛋白联合环孢素治疗重型再生障碍性贫血的疗效观察

The efficacy of antithymocyte globulin combined with cyclosporine immunosuppressive therapy in the treatment of severe aplasfic anemia

目的探讨重型再生障碍性贫血（SAA）患儿进行抗胸腺细胞球蛋白（ATG）联合环孢素（CSA）免疫抑制治疗的疗效。方法收集SAA患儿20例，均给予ATG联合CSA免疫抑制治疗，观察患儿治疗前后血液指标变化。结果患儿经过治疗后治愈4例（13．33％），缓解11例（36．67％），明显进步8例（26．67％），无效7例（23．33％），总有效率为76．67％。经过治疗血常规检查患儿Hb、WBC、PLT治疗6个月与治疗前相比，差异均有统计学意义（t=5．678、3．675、7．685，均P〈0．05）。患儿经过治疗1例出现变态反应，占3．33％，最后给予糖皮质激素后好转；1例患儿用药后出现WBC极度低下，占3．33％，经过检测出现严重感染，最后死亡。结论ATG联合CSA免疫抑制治疗SAA治疗效果明显，具有一定安全性，值得临床推荐。

Objective To investigate the effect of anti thymic globulin （ATG） combined with cyclosporine （CSA） immunosuppressive therapy in patients with severe aplastic anemia （SAA）. Methods 20 patients with SAA were treated with CSA combined with immunosuppressive therapy, and the changes of blood indexes after treatment were observed. Results After treatment,4 cases （ 13.33% ） were cured,ll cases （36.67%） were relieved,8 cases （26.67%） were improved, 7 cases （23.33%） were ineffective, the total effective rate was 76.67%. After the treatment of blood routine, examination of Hb, WBC and PLT treatment 6 months compared with before treatment,the difference were statistically significant （t = 5. 678,3. 675,7. 685, all P 〈 0.05 ）. Patients after treatment, 1 case had allergic reaction,which accounted for 3.33%, and was finally given the glucocorticoid, then improved. 1 case had extremely low WBC, accounting for 3.33%, appeared serious infection and death after testing. Conclusion The effect of ATG combined with CSA immunosuppression in the treatment of SAA is effective obviously, and it has a certain safety, vwhich is worthy of clinical recommendation.