环孢素A选择性治疗10例全血细胞减少患者的临床研究  

Clinical Study on 10 Cases of Pancytopenia Selectively Treated by Cyclosporine A

作　　者：仇红霞[1] 李建勇[1] 许戟[1] 吕鑫[1] 徐卫[1] 张苏江[1] 吴汉新[1] 邵景章[2] 

机构地区：[1]南京医科大学第一附属医院、江苏省人民医院血液科,江苏南京210029 [2]苏州大学第一附属医院血液科,江苏苏州215006

出　　处：《中国实验血液学杂志》2009年第4期1047-1051,共5页Journal of Experimental Hematology

摘　　要：本研究探讨环孢素A(CsA)选择性治疗网织红细胞(Ret)不低且伴乳酸脱氢酶(LDH)升高的全血细胞减少患者的疗效及不良反应。设定入选标准,用CsA对10例入组患者进行治疗,随访6-116月,评价疗效及不良反应。列举典型病例演示CsA在再生障碍性贫血(AA)伴LDH显著升高患者中的维持治疗作用。结果表明:10例患者诊断不同,但具有相似的临床及实验室特征,其中9例患者对CsA治疗有较好的反应,1例因肺结核终止治疗。结论:Ret不低伴LDH升高可能是CsA治疗全血细胞减少有反应的预测标记物。CsA选择性治疗可获得较高的反应性。CsA维持治疗是减少复发的重要因素。This study was aimed to explore the effect and adverse reaction of cyclosporine A （CsA） in treatment of pancytopenia without reticulocyte decrease but with elevated LDH. 10 patients were selected according to our standards and were treated by CsA. The curative effect and adverse reaction of patients were evaluated by following up for 6 - 116 months. The effect of CsA in the maintenance treatment of AA patient with an obvious rise of LDH was illustrated by means of typical case. The results indicated that 10 patients had different diagnosis, but had similar clinical and laboratory characteristics. Among them, 9 patients showed a relatively good curative reaction to CsA. Treatment of 1 patient was stoped because of pneumotuberculosis. It is concluded that the elevated LDH without reticuleocyte decrease may be a biomarker to predict the curative reaction to CsA for patients with pancytopenia. Selectively treating pancytopenia with CsA can obtain a higher curative reaction and maintenance treatment with CsA is an important factor for reducing recurrence of this disease.

关 键 词：全血细胞减少 再生障碍性贫血 骨髓增生异常综合征 环孢素A 乳酸脱氢酶 

分 类 号：R555[医药卫生—血液循环系统疾病] R557[医药卫生—内科学]