两种免疫抑制疗法治疗再生障碍性贫血疗效及对细胞因子的影响对比

Comparison of the efficacy of two immunosuppressive therapies in the treatment of aplastic anemia and their effects on cytokines

目的对比两种免疫抑制疗法治疗再生障碍性贫血的疗效及对细胞因子的影响。方法选取阳城县人民医院自2018年5月-2020年5月收治的再生障碍性贫血患者90例,采用随机数字表法分为对照组与观察组,各45例。2组均给予基础治疗,对照组加用环孢素A治疗,观察组在对照组基础上加用抗淋巴细胞球蛋白治疗,对比2组临床疗效以及治疗前后细胞因子白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、白细胞介素-3(IL-3)及干扰素-γ(IFN-γ)水平,同时观察不良反应。结果观察组与对照组相比临床总有效率更高,差异有统计学意义(P<0.05)。观察组治疗后与对照组相比IL-8、TNF-α及INF-γ水平更低,IL-3水平更高,差异有统计学意义(P<0.05)。2组不良反应发生率相比无明显差异(P>0.05)。结论抗淋巴细胞球蛋白联合环孢素A治疗再生障碍性贫血可获得较好的临床疗效,同时可促进细胞因子改善,且不会明显增加不良反应,安全性较高。

Objective e To explore and analyze the efficacy of two immunosuppressive therapies in the treatment of aplastic anemia and their influence on cytokines.Methods A total of 90 patients with aplastic anemia admitted to our hospital from May 2018 to May 2020 were selected and divided into a control group and an observation group with a random number table method,each with 45 cases.Both groups were given basic treatment,control The group was treated with cyclosporin A,and the observation group was treated with anti-lymphocyte globulin on the basis of the control group.The clinical efficacy and the cytokine interleukin-8(IL-8)and tumor necrosis factor-before and afer treatment were compared between the two groups.α(TNF-α),interleukin-3(IL-3)and interferon-γ(IFN-γ)level changes,while observing adverse reactions.Results Compared with the control group,the observation group had a higher clinical total effective rate,and the difference was statistically significant(P<0.05).IL-8 levels in the observation group were compared with those in the control group after treatment.Decrease,TNF-αlevel decreased,IL-3 level increased,INF-γlevel was lower,the difference was statistically significant(P<0.05).There was no significant difference in adverse reactions between the two groups(P>0.05).Conclusion The combination of antilymphocyte globulin and cyclosporine A in the treatment of aplastic anemia can achieve a good clinical effect,and it can also promote the regulation and improvement of the level of cytokines without increasing adverse reactions and has high safety.