Logistic回归分析再生障碍性贫血免疫疗法治疗效果的因素研究

Logistic Regression Analysis of Factors Affecting the Therapeutic Effect of Immunotherapy For Aplastic Anemia

目的 探讨再生障碍性贫血(AA)免疫疗法的治疗效果及其影响因素。方法 选取70例AA患者,所有患者均采用免疫疗法(环孢素+抗胸腺细胞球蛋白)治疗,持续治疗6个月,参照相关标准评估并记录患者的治疗效果并分为有效组和无效组;设计一般资料调查问卷,询问并记录患者的一般资料和实验室相关指标,分析AA患者免疫疗法治疗效果的影响因素。结果 70例AA患者免疫疗法治疗6个月后,经评估,45例评估为有效率,有效率为64.29%;25例评估为无效,无效率为35.71%;无效组治疗前中性粒细胞绝对值(ANC)、网织红细胞计数(Ret)水平低于有效组,骨髓造血面积小于无效组,差异有统计学意义(P<0.05);经Logistic回归分析,Ret、ANC水平高、骨髓造血面积大是AA免疫疗法治疗无效的保护因素(OR<1,P<0.05)。结论 ANC、Ret水平高、骨髓造血面积大是AA免疫疗法治疗效果的保护因素。

Objective To investigate the therapeutic effect and influencing factors of immunotherapy for aplastic anemia(AA).Methods 70 AA patients treated were selected.All patients were treated with immunotherapy(cyclosporine + antithymocyte globulin)for 6 months.The treatment effect was evaluated and recorded according to relevant standards,and divided into effective group and ineffective group;Design a general data questionnaire,ask and record the general data and laboratory related indicators of patients,and analyze the influencing factors of immunotherapy in AA patients.Results After 6 months of immunotherapy in 70 AA patients,45 cases were evaluated as effective,and the effective rate was 64.29%(45/70);25 cases were evaluated as ineffective,and the ineffective rate was 35.71%(25/70);Before treatment,the absolute value of neutrophils(ANC)and reticulocyte count(RET)in the ineffective group were lower than those in the effective group,and the hematopoietic area of bone marrow was smaller than that in the ineffective group(P <0.05);Logistic regression analysis showed that high levels of RET and ANC and large hematopoietic area of bone marrow were the protective factors for the ineffective treatment of AA immunotherapy(or<1,P<0.05).Conclusion High levels of ANC and RET and large hematopoietic area of bone marrow are the protective factors for the therapeutic effect of AA immunotherapy.