自身免疫性溶血性贫血127例临床分析  

Clinical analysis 127 cases with autoimmune hemolytic anemia

作　　者：熊晶[1] 吴学琼[1] 孙汉英[1] 肖毅[1] 刘文励[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院血液科,武汉430030

出　　处：《临床血液学杂志》2007年第4期225-227,共3页Journal of Clinical Hematology

摘　　要：目的：研究自身免疫性溶血性贫血的临床特征。方法：对127例自身免疫性溶血性贫血的临床资料进行回顾性分析。结果：①127例中病因明确者41例（32．3％），感染性疾病16例（39．0％），且感染是疾病复发或病情加重最常见的诱因，与药物有关病例5例（12．2％）。②抗体分型与临床及预后相关：IgG＋C3型溶血较重，C3型溶血较轻，IgG型介于两者之间；C3型完全缓解率较高。③误诊病例15例（11．8％）。④糖皮质激素加用免疫抑制剂治疗或糖皮质激素加用大剂量静脉免疫球蛋白治疗疗效优于单用糖皮质激素治疗（P〈0．01）。结论：AIHA抗体分型与临床及预后相关；基础疾病的追查及治疗有重要意义；应重视临床表现及实验室特征以防止误诊病例的发生；糖皮质激素加用免疫抑制剂或加用大剂量静脉免疫球蛋白的治疗方法疗效较好。Objective：To investigate the clinical characteristics of autoimmune hemolytic anemia. Method：Clinical data of 127 cases with autoimmune hemolytic anemia was retrospectively reviewed. Result： （1） Among the 127 patients, causes of 41 patients were clear, in which the infectious disease was the most common. Drug-related cases were worthy of note. AIHA can be the initial manifestation of lymphoproliferative disease and systemic lupus erythematosus, and the follow-up study of the basic disease can be greatly significant to the treatment of A/HA. （2）Hemolysis and prognosis were related with the type of the autoantibody. （3）There were 15 missed cases. （4）The complete response rate of group of corticosteroid combined with immunosuppressive drugs and group of corticosteroid combined with intravenous immunoglobulin were respectively higher than that of group of corticosteroid （P〈 0.01 ）. Conclusion：Prognosis of AIHA are related with the type of the autoantibody. The great significance of the follow-up study and treatment of the basic disease should be realized. The feature of clinical manifestation and laboratory examination should be taken seriously to avoid misdiagnosis. Corticosteroid combined with immunosuppressive drugs or intravenous immunoglobulin can improve the complete response rate.

关 键 词：自身免疫性 溶血性 贫血 临床研究 

分 类 号：R556.62[医药卫生—血液循环系统疾病]