ATG联合环孢素A治疗重型再生障碍性贫血近期疗效分析

Short-term Efficacy of ATG Combined with Cyclosporine A in the Treatment of Severe Aplastic Anemia

目的分析ATG联合环孢素A治疗重型再生障碍性贫血的近期效果。方法该次研究对象选取在该院接受治疗的重型再生障碍性贫血患者50例,收治时间为2012年4月—2017年6月,给予患者ATG联合环孢素A的治疗。观察患者的白细胞和血小板恢复时间以及治疗效果,检测患者在治疗前后的血细胞以及免疫细胞的水平,并且对患者治疗1年后的复发率加以分析。结果患者的临床总有效率为62.0%,白细胞中位恢复时间30 d、血小板中位恢复时间为98 d,1年后的复发率为16.0%。在治疗后,患者的白细胞计数、血红蛋白以及血小板计数结果分别为(5.34±0.42)×10~9/L、(112.28±10.31)g/L和(127.45±11.27)×10~9/L,其和治疗前相比均显著优于治疗前,数据比较差异有统计学意义(P<0.05)。患者在治疗后的CD_4^+、CD_8^+和CD_4^+/CD_8^+的指标分别为(37.38±7.26)%、(28.15±6.96)%和(1.36±0.63),其与治疗前相比差异有统计学意义(P<0.05)。结论 ATG联合环孢素A治疗重型再生障碍性贫血的临床疗效较为显著,且安全性更高,患者的血液和免疫功能也得到了较为显著的改善,值得临床推广。

Objective To analyze the short-term effects of ATG combined with cyclosporine A in the treatment of severe aplastic anemia.Methods Fifty patients with severe aplastic anemia who were treated in the hospital were enrolled in this study. The patients were treated with ATG combined with cyclosporine A from April 2012 to June 2017. Observe the patient＇s white blood cell and platelet re-covery time and treatment effect, detect the blood cells and immune cells of patients before and after treatment, and analyze the re-currence rate after one year of treatment. Results The total clinical effective rate was 62.0%, the median recovery time of white blood cells was 30 days, the median platelet recovery time was 98 days, and the recurrence rate was 16.0% after one year. After treatment,the patients＇ white blood cell count, hemoglobin and platelet count were（5.34±0.42）×10-9/L,（112.28±10.31）g/L and（127.45±11.27）g/L,respectively, which were significantly better than before treatment,. The difference was statistically significant（P〈0.05）. The CD4^＋,CD8^＋and CD4^＋/CD8^＋indexes of the patients after treatment were（37.38±7.26）%,（28.15±6.96）% and（1.36±0.63）, the difference was statistically significant, compared with that before treatment（P〈0.05）. Conclusion The clinical efficacy of ATG combined with cyclosporine A in the treatment of severe aplastic anemia is more significant, and the safety is higher. The blood and immune function of the patients have also been significantly improved, which is worthy of clinical promotion.