小剂量环孢素联合达那唑对慢性再生障碍性贫血患者的疗效分析

Effect of low-dose cyclosporine combined with danazol on chronicaplastic anemia

目的 探讨小剂量环孢素联合达那唑治疗慢性再生障碍性贫血患者的治疗效果,并分析其对患者外周血象的影响。方法 回顾性分析2014年7月~2016年6月山东大学第二医院接受治疗的68例慢性再生障碍性贫血患者的临床资料,根据治疗方法分为对照组和观察组,对照组给予常规剂量环孢素联合达那唑治疗,观察组给予小剂量环孢素联合达那唑治疗,4 w为一个疗程。治疗2个疗程后,观察2组患者的治疗效果,比较2组患者治疗前后骨髓象、外周血象、免疫球蛋白水平的变化。结果 观察组治疗有效率为96.97%,明显高于对照组77.14%（F=6.563,P=0.028）。治疗后,观察组骨髓象较对照组明显改善（P〈0.05）;观察组Tbet、GATA-3和STAT4水平均低于对照组（P〈0.05）;观察组WBC、Hb、PLT和RET水平均较高于对照组（P〈0.05）;2组患者治疗后血清免疫球蛋白水平差异无统计学意义;2组患者肝肾功能异常、胃肠道反应、多毛和痤疮发生率差异无统计学意义。结论 小剂量环孢素联合达那唑对慢性再生障碍性贫血患者有较好的治疗效果,可明显改善患者的血象和骨髓象,且安全性高。

Objective To study the effect of low-dose cyclosporine combined with danazol on chronic aplastic anemia, and to analyze the influence on peripheral hemogram. Methods R e trospectively analyzed the clinical data of 68 patients with chronic aplastic anemia treated from J u l y 2014 to June 2016 in the second hospital of shandong university, according to their treatment methods were divided into control group and observation group, the control group was given conventional dose of cyclosporine combined with danazol, the observation group received low-dose of cyclosporine combined with danazol, four weeks for a course of treatment. After two courses of treatment, observe the curative effect of two groups, the difference of bone marrow, peripheral blood, immunoglobulin levels before and after treatment were compared in the two groups. Results T h e effective rate of t h e o b s e r v a t i o n g r o u p was 96. 97% , which was significantly higher than that of the control group 77. 14% （F = 6. 5 6 3 , P = 0. 0 2 8 ）. A f t e r t r e a t m e n t , t h e b o n e m a r r o w of the observation group was significantly improved compared with the control group （P 〈 0. 05 ） ; the levels of T - b e t , G ATA-3 a n d ST A T 4 of t h e o b s e r v a t i o n group were lower than those of control group （ P 〈 0. 05 ） , the levels of WBC, Hb, PLT and RET were higher in the observation group than in the control group （P 〈0. 05） ; there was no significant difference in serum immunoglobulin level between the two groups after treatment, there was no significant difference in the incidence of liver and renal function, gastrointestinal reaction, hairy and acne between the two groups. Conclusion L o w - d o s e cyclosporine combined with danazol has better therapeutic effect in the treatment of chronic aplastic anemia, can significantly improve the hemogram and myelogram of patients, has good clinical value high security.