强化免疫抑制治疗儿童再生障碍性贫血疗效分析  

Intensive Immunosuppressive Therapy for Children with Severe Aplastic Anemia

作　　者：黄科[1] 黄绍良[1] 方建培[1] 钟凤仪[1] 周敦华[1] 李栋方[1] 岑丹阳[1] 

机构地区：[1]中山大学附属第二医院儿科,广东广州510120

出　　处：《中山大学学报（医学科学版）》2004年第5期486-488,共3页Journal of Sun Yat-Sen University:Medical Sciences

摘　　要：【目的】探讨强化免疫抑制治疗儿童再生障碍性贫血的疗效及毒副作用的防治。【方法】总结我科1996—2003年儿童再障32例,均采用强化免疫抑制治疗(IIST),根据免疫抑制药物的不同组合分为2组:4种药物联合组和2～3种药物联合组。【结果】总有效率为71.88%,4种药物联合组、2～3种药物联合组有效率分别为72.2%及71.33%,差别无显著性。治疗过程中,致命的合并症为败血症,尤其潜伏病毒激活及深部真菌感染。随访中没有病例发展为阵发性睡眠性血红蛋白尿(PNH),骨髓异常增生综合征(MDS)或急性粒细胞性白血病(AML)。【结论】CSA与ALG/ATG、HDIVIG、HDMP有良好的协同作用,IIST有利于更进一步提高儿童SAA的疗效。To study the efficacy and side effects of intensive immunosuppressive therapv(IIST)in children with severe aplastic anemia(SAA).From January 1996to January 2003,32patients with SAA were treated in o ur hospital by IIST,mainly consisted of cyclosporin(CSA),antilymphocyte gobulin(ATG /ALG),high dose immunoglobulin(HDIVIG)and high dose prednisone(HDMP ).They were divided into two groups:group A with4immunosuppressive agents,group B with 2or 3immunosuppressive agents.The total response rate was 71.88%.No significant difference between the tw o groups was found.The fatal complication was septicemia,which was caused especially by the activation of latent virus and deep fungal infection.At present ,no patient developed diseases of paroxysmal nocturnal hemoglobinuria(PNH),myelodysplastic syndromes(MDS)or acute myelogenous leukemia(AML ).[Conclusion]CSA combined with ALG /ATG,HDIVIG and HDMP can increase the resp onse rate in SAA.IIST can further improve the eff icacy of SAA in children.

关 键 词：治疗 强化免疫 再生障碍性贫血 联合 儿童 抑制 疗效分析 

分 类 号：R556.5[医药卫生—血液循环系统疾病] R735.7[医药卫生—内科学]