粒细胞集落因子治疗急性再生障碍性贫血临床价值

Clinical value of granulocyte colony-stimulating factor in treatment of acute aplastic anemia

目的探讨粒细胞集落因子(G-CSF)治疗急性再生障碍性贫血的临床效果。方法采用回顾性的研究方法对北京军区总医院2008—2014 年收治的62 例急性再生障碍性贫血的患者的治疗情况进行研究,根据治疗方法分为G-CSF 组(37例)和对照组(25 例),对照组采用雄激素结合常规疗法,G-CSF 组在对照组基础上加用G-CSF 治疗,比较两组患者治疗前与治疗后不同时间的外周血指标、T 细胞亚群指标及临床疗效差异。结果治疗前两组患者的Hb、PLT 检测值差异不显著,治疗第30 天G-CSF 组的Hb(74.5±15.3)g/L、PLT(27.4±8.8)×109/L 值显著高于对照组(P<0.05)。治疗前两组患者的WBC 水平差异不显著,治疗第7、14、30 天 G-CSF 组患者的WBC 水平显著高于对照组(P<0.05)。治疗前两组患者的CD3+、CD4+、CD8+、CD4+/CD8+值比较差异不显著,治疗第30 天G-CSF 组患者的CD8+细胞显著低于对照组(P<0.05),CD4+/CD8+值显著高于对照组(P<0.05)。G-CSF 组患者的发热时间(7.5±3.6)d、感染持续时间(13.4±5.6)d 显著低于对照组(P<0.05)。治疗6 个月后,G-CSF 组的总有效率78.38%显著高于对照组的52.00%(P<0.05),治疗过程中G-CSF 组有2 例患者死亡(5.41%),低于对照组的4 例(16%),但差异不具有统计学意义。结论常规治疗基础上加用粒细胞集落因子治疗急性再生障碍性贫血对于改善患者的血常规指标、缓解临床症状、提高治疗效果具有显著意义。

Objective To investigate the clinical effect of granulocyte colony-stimulating factor (G-CSF) in the treatment of acute aplastic anemia. Methods A retrospective study of 62 cases of acute aplastic anemia treatment of patients in General Hospital of Beijing Military Region from 2008 to 2014 as performed. The patients were divided into G-CSF treatment group (37 cases) and control group (25 cases), the patients in control group received conventional therapy of androgen binding, and the patients in G-CSF group were added with the use of G-CSF treatment. The peripheral targets at different time after treatment, T cell subsets targets, and clinical efficacy between the two groups were compared. Results The Hb and PLT values in two groups before treatment were detected without significant difference (P> 0.05), and after G-CSF treatment group Hb 74.5 ± 15.3 (g/L), PLT 27.4 ± 8.8 (109/L) was significantly higher than in the control group (P <0.05). WBC level between the two groups before treatment, the patient was not significant (P> 0.05), after treatment, the level of the first WBC 7, 14, 30 d G-CSF group were significantly higher than the control (P<0.05). Treatment groups were pre-CD3+, CD4+, CD8+, CD4+/CD8+ value difference was not significant (P> 0.05), after treatment,G-CSF group of patients with CD8 + cells were 0.30±0.04 was significantly lower than the control group (P <0.05), CD4+/CD8+ value of 0.83±0.04 was significantly higher (P <0.05). G-CSF group of patients with fever 7.5±3.6 (d), infection duration 13.4±5.6 (d) was significantly lower than the control group (P <0.05). After 6 months of treatment, the total G-CSF group 78.38% significantly higherthan the 52.00% (P <0.05) the efficiency of the treatment process, G-CSF group 2 patients died (5.41%) than the control 4 cases(16%) group but the difference was not statistically significant (P> 0.05). Conclusion Conventional therapy based on the use of granulocyte colony-factor treatment of acute aplastic anemia patients to improve blood indicators, relieve symptoms, improve treatment has significant meaning.