摘要
目的:探讨重型再生障碍性贫血(简称重型再障)以补肾中药联合抗淋巴细胞球蛋白/抗胸腺细胞球蛋白(ALG/ATG)为主的免疫抑制剂治疗效果、影响疗效因素。方法:采用补肾中药联合ALG/ATG对重型再障患者进行治疗,辅以环孢菌素A、雄激素、粒细胞集落刺激因子等。结果:①可评价的71例重型再障患者中(随访1年以上)基本治愈30例(42.3%),缓解11例(15.5%),明显进步18例(25.4%),无效12例(16.9%),总有效率为83.1%。②新诊断重型再障患者的中性粒细胞绝对值高于0.2×109/L时疗效较好(P=0.0001),网织红细胞绝对值高于10×109/L时疗效较好(P=0.001)。但性别(P=0.320)、年龄(P=0.563)、病程(P=0.334)、血小板(P=0.621)、骨髓淋巴细胞(P=0.632)与重型再障疗效无明显关系。③通过Kaplan-Meier过程对可能影响重型再障患者生存期的因素进行多因素分析,发现年龄(P=0.026)大于60岁的患者生存期明显缩短,但中性粒细胞计数(P=0.288)、网织红细胞计数(P=0.205)、血小板计数(P=0.917)、骨髓的淋巴细胞比例(P=0.914)、发病至使用ATG/ALG的时间(P=0.093)对生存期的影响无统计学意义。结论:应用补肾中药联合ATG/ALG治疗重型再障,发病时中性粒细胞绝对值>0.2×109/L、网织红细胞绝对值高于10×109/L似可作为预测治疗有效指标,年龄大于60岁的患者生存期短,预后差。
Objective：To analyze the effectiveness and prognostic factors of antithymus globulin（ATG）/ antilymphocyte globulin（ALG） together with herbs of nourishing the kidney in treatment of severe aplastic anemia（SAA）.Method：Clinical data of 71 cases with severe aplastic anemia who received ATG/ALD treatment from 1992 to 2009 were analyzed retrospectively.Result：In the 71 patients,30 were nearly cured（42.3%）,11 were relieved（15.5%）,18 were improved（25.4%） and 12 were invalid（16.9%）,The overall effective rate was 83.1%.Among all the factors,we found that neutrophil counts（ANC） more than 0.2 × 109/L（P=0.0001） and the reticulocyte more than 10 × 109/L（P=0.001）indicated a higher remission rate,while sex（P=0.320）,age（P=0.563）,course of disease（P=0.334）,platelet count（P=0.621）,the percentage of lymphocyte in bone marrow slides less than 60%（P=0.632） had no relation with treatment results.And another research on survival rate found that patients with age over 60 had shorter life span than their counterparts.However,ANC（P=0.288）,reticulocyte count（P=0.205）,platelet count（P=0.917）,the percentage of lymphocyte in bone marrow slides（P=0.914）,the course of disease before use ATG/ALG（P=0.093） were not related with survival.Conclusion：ATG/ALG together with Chinese herbs in treatment of severe aplastic anemia was valid and safe,which could also improve clinical curative effect and increase patients’survival rate.ANC more than 0.2 × 109/L and the reticulocyte more than 10 × 109/L would be prognostic factors for efficiency in SAA.
出处
《中国实验方剂学杂志》
CAS
北大核心
2011年第8期250-254,共5页
Chinese Journal of Experimental Traditional Medical Formulae
关键词
再生障碍性贫血
重型
补肾中药
ATG/ALG
预后因素
aplastic anemia,severe； herbs of nourishing the kidney； antilymphocyte globulin； antithymus cell globulin； prognostic factor；
