抗胸腺细胞球蛋白联合环孢素A治疗重型再生障碍性贫血疗效分析

【摘要】目的探讨应用抗胸腺细胞球蛋白（ATG）联合环孢素A（CSA）治疗重型再生障碍性贫血（SAA）的临床疗效，观察其对血液和免疫功能的改善作用及安全性。方法选择2011年1月至2015年75再生障碍性贫血（AA）患者36例，应用ATG联合CSA治疗。观察患者治疗效果。白细胞和血小板恢复时间．检测患者治疗前后血细胞及免疫细胞水平，观察治疗1年后复发率。结果完全缓解5例（13．89％）、部分缓解17例（47．22％）、无效14倒（38．89％）。白细胞中位恢复时间29d，血小板中位恢复时间6个月。观察一年后复发6例（16．67％）。治疗后患者白细胞计数、血红蛋白和血小板计数结果分别为（5．33±O．92）×10^9/L、（112．26±10．30）g／L和（127．43±11．26）×10^9／L，均高于治疗前，差异有统计学意义（P〈0．05），患者治疗后CD4＋和CD4＋／CD8＋分别为（37．39±7．28）％和（1．33±O．61）％，高于治疗前，治疗后CD8＋为（28．14±6．93）％，低于治疗前，差异均有统计学意义（P〈0．05）。结论ATG联合csA治疗SAA患者具有较好的临床疗效与安全性，显著改善患者血液和免疫功能。

Objective To explore the clinical effect of the treatment of severe aplastic anemia by using the combination of.anti -globulin globulin （ ATG ） and cyclosporine A （ CSA ） , and to observe the improvement of the blood and immune function and its security.Methods 36 patients with AA treated were selected from January in 2011 to July in 2014, treated by ATG combined with CSA. Select January 2011 ~ July 2015 in AA patients with the diagnosis and treatment of 36 cases of the Court, the application ATG joint CSA treatment. Observed treatment effect of the patients, white blood cell and platelet recovery time, detect blood cells and immune cell levels before and after treatment, observed relapse rate after treatment one year. Results The Complete remission in 5 patients （ 13.89% ） , partial remission in 17 patients （ 47.22% ） , the median recovery time was leukocytes 29d, the median platelet recovery time was six months, 14 cases （ 38.89% ） was invalid patients. One year later the recurrence was 6 patients （16.67%）.Aftertreatment, white blood cell count, hemoglobin and platelet counts were （5.33±0.92） ×10^9/L, （112.26±10.30） g/L and （ 127.43 ±11.26 ） × 10^9/L, were higher than before treatment, the difference was statistically significant （ P〈0.05 ） . CD4＋ and CD4/CD8＋ after treatment were （ 37.39 ± 7.28 ） % and 1.33 ± 0.61, higher than that before treatment, CD8 ＋ was （ 28.14 ± 6.93 ） %, lower than that before treatment, the differences were statistically significant （ P〈0.05 ） . Conclusion ATG joint CSA treatment patients with SAA had better clinical efficacy, it can significantly improve a patient＇s blood and immune function, and has better security.