重组粒细胞集落刺激因子对再生障碍性贫血并感染患者免疫功能的影响

Effects of recombinant human granulocyte colony stimulating factor on immune function in patients with aplastic anemia complicted with infection

目的探讨重组人粒细胞集落刺激因子(rh G-CSF)对再生障碍性贫血(AA)并感染患者免疫功能的影响。方法回顾性分析2011年1月~2014年6月海南省人民医院收治的140例AA并感染患者资料,其中采用rh GCSF联合环孢霉素治疗72例,作为实验组;单纯采用环孢霉素治疗68例,作为对照组。比较两组治疗后临床效果、感染相关死亡率、克隆演变发生率、外周血象及T细胞亚群变化。结果实验组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05);实验组感染相关死亡率低于对照组,克隆演变发生率高于对照组,但两组比较差异无统计学意义(P>0.05);实验组治疗后外周血白细胞计数、血小板计数、血红蛋白均较治疗前升高(P<0.05),CD3^+、CD4^+较治疗前下降(P<0.05),而CD8^+较治疗前升高(P<0.05),治疗后实验组各指标改善均明显优于对照组(P<0.05)。结论 rh G-CSF对AA并感染治疗效果显著,感染发生率低,促进免疫功能恢复,安全可靠,值得临床借鉴。

Objective To explore the effects of recombinant human granulocyte colony stimulating factor （rhG-CSF） on immune function in patients with aplastic anemia （AA） complicted with infection. Methods Tile data of 140 cases of patients with AA complicted with infection in Hainan Provincial People＇s Hospital from January 2011 to June 2014 were retrospective analyzed. There were 72 patients treated with rhG-CSF combined with Cyclopsorin, taken as the ex- perimetal group; and the other 68 cases of patients only treated with Cyclopsorin were taken as the qontrol group. The therapeutic effect, mortality related to infection, rates of clonal evolution and changes of peripheral blood cells and T cell subsets levels of the two groups after treatment were compared. Results The total effective rate of the experimetal group wa significantly higher than that of the control group （P 〈 0.05）. The mortality related to infection of the experimet- al group was lower and the rate of cl0nal evolution was higher than those of the control group, but there were no significant differences between the two groups （P 〉 0.05）. In the experimetal group, after treatment the WBC, PLT, Hb levies increased, CD3＋and CD4＋ levels decreased and CD8＋ level increased than those of before treatment, with statistically significant differences （P 〈 0.05）; while those indexes of the expefimetal group were all significantly improved than the control group （P 〈 0.05）. Conclusion The treatment effect of rhG-CSF in patients with AA complicted with infection is remarkable, with low infection rate, which can promote the recovery of immune function, safe and reliable, and it is worthy of clinical reference.