摘要
目的研究环孢素A治疗再生障碍性贫血患者的疗效及对辅助性T细胞(Th细胞)、白细胞介素4(IL-4)和干扰素γ(IFN-γ)的影响。方法选择2011年2月至2014年3月在德州市人民医院进行治疗的再生障碍性贫血患者144例,根据随机数字法分为观察组(72例)和对照组(72例)。对照组采用司坦唑醇治疗,每次3 mg,每日3次,连续治疗6个月;观察组口服环孢菌素A治疗,5 mg/(kg·d),每日3次。治疗后对两组患者的临床疗效进行评估,同时在治疗前后对两组患者血液指标(白细胞计数、血红蛋白、血小板)、Th细胞亚群、IL-4与IFN-γ水平进行测定。结果观察组总有效率显著高于对照组[97.2%(70/72)比84.7%(61/72),P<0.05]。治疗后,观察组白细胞计数,血红蛋白含量均显著高于对照组[(4.09±0.83)×10~9/L比(2.91±0.23)×10~9/L,(132±13)g/L比(115±16)g/L,P<0.01]。治疗后,观察组Th1和Th1/Th2值均显著低于对照组[(9.83±1.03)%比(16.13±2.13)%,(9.14±1.07)比(14.38±3.76)],差异有统计学意义(P<0.01),两组Th2比较差异无统计学意义(P>0.05)。治疗后,观察组IFN-γ水平显著低于对照组[(29±4)ng/L比(36±7)ng/L,P<0.01],两组患者IL-4水平比较差异无统计学意义(P>0.05)。结论环孢素A治疗再生障碍性贫血临床疗效确切,其作用机制可能是其能够降低Th1细胞、Th1/Th2比值和IFN-γ水平。
Objective To study the effect of cyclosporine A on the treatment of patients with aplastic anemia and the effect on Th cells,intierleukin( IL-4) and interferon-γ( IFN-γ) of patients with aplastic anemia. Methods Total of 144 patients treated in Dezhou People’s Hospital from Feb. 2011 to Mar. 2014 were included in the study and divided into a observation group( 72 cases) and a control group( 72 cases) according to the random number method. The control group received stanozolol treatment,3 mg / time,3 times a day,continuously for 6 months. The treatment group was treated with cyclosporin A,5 mg /(d · kg),3 times a day. The clinical efficacy of two groups after treatment,the Th cells,IL-4 and IFN-γ of the two groups were determined before and after treatment. Results The total effective rate of the observation group was significantly higher than the control group[97. 2%( 70 /72) vs 84. 7%( 61 /72),P < 0. 05]. After treatment,the white blood cell count and hemoglobin content of the observation group were significantly higher than the control group[( 4. 09 ± 0. 83) × 10~9/ L vs( 2. 91 ± 0. 23) × 10~9/ L,( 132 ± 13) g / L vs( 115 ± 16) g / L,P <0. 01]. After treatment,Th1 and Th1 / Th2 values of the observation group were significantly lower than the control group[( 9. 83 ± 1. 03) % vs( 16. 13 ± 2. 13) %,( 9. 14 ± 1. 07) vs( 14. 38 ± 3. 76) ],and the differences were statistically significant( P < 0. 01),the differences of Th2 between the two groups had no statistical significance( P > 0. 01). After treatment,the level of IFN-γ in the observation group was significantly lower than the control group[( 29 ± 4) ng / L vs( 36 ± 7) ng / L,P < 0. 01],and there was no significant difference in IL-4 level between the two groups( P > 0. 05). Conclusion Cyclosporine A has definite clinical effect on the treatment of aplastic anemia,and its mechanism of efficacy may be the declination of Th1 cells,Th1 / Th2 ratio and IFN-γ level.
出处
《医学综述》
2016年第23期4765-4768,共4页
Medical Recapitulate
