摘要
目的 探寻进一步降低复治的慢性再生障碍性贫血 (CAA)患者死亡率并提高疗效的方法。 方法采用前瞻性同期对照研究法 ,比较雄激素单用与雄激素并用环孢素联合造血生长因子 (促红细胞生成素、粒 -巨噬细胞集落刺激因子或粒细胞集落刺激因子 )治疗复治的CAA患者疗效。 结果 雄激素并用环孢素联合造血生长因子者不仅有效率(64.0 %vs30.4%)、感染率(16.0 %vs56.5%)、死亡率(8.0%vs39.1%) ,而且在成分输血脱离时间及骨髓造血祖细胞体外培养方面均优于单用雄激素者。且治疗毒副作用轻 ,患者均能耐受。结论 雄激素并用环孢素和造血生长因子治疗复治的慢性再生障碍性贫血 ,可降低患者死亡率和感染率 ,临床疗效较好。
Objective To explore the effective regime to reduce the mortality of refractory and recurrent chronic aplastic anemia(CAA).Methods The method of prospective and synchronized control was adopted. Fifty two CAA patients were treated with androgen alone, or treated by androgen combined with cyclosporine A(CsA) and hematopoietic growth factors (HGFs: Epo), Erythropoietin (Epo and GM-CSF or G-CSF) and the results of two groups were compared.Results The combined therapy group was superior to the androgen group not only in therapeutic effect rate (64.0% vs 30.4%), infection rate (16.0% vs 56.5%) and mortality rate(8.0% vs 39.1%), but also in shorter duration of blood transfusion and in vitro culture of bone marrow hematopoiesis. The combined use of androgen with CsA and HGFs in the treatment of recurrent chronic aplastic anemia yielded less toxic and side effects.Conclusion Based on androgen with CsA immuno-inhibitory therapy, the combined use of HGFs could reduce both the mortality rate and infection rate in the treatment of recurrent refractory chronic aplastic anemia.
出处
《浙江医学》
CAS
2002年第12期715-717,720,共4页
Zhejiang Medical Journal
