抗T单抗治疗再生障碍性贫血的疗效因素分析  

ANALYSIS OF EFFECT RELATED FACTORS IN PATIENTS WITH APLASTIC ANEMIA TREATED WITH ANTI T LYMPHOCYTE MONOCLONAL ANTIBODIES

作　　者：李杰[1] 张明珙[1] 宋素芹[1] 王欣[1] 宋强[1] 赵川莉[1] 郭承山[1] 王芹[1] 

机构地区：[1]山东医科大学附属医院血液科

出　　处：《山东医科大学学报》1999年第3期220-222,共3页Acta Academiae Medicinae Shandong

摘　　要：再障 ９７ 例（ Ｓ Ａ ＡⅠ ２１ 例， Ｓ Ａ ＡⅡ ３４ 例， Ｃ Ａ Ａ ４２ 例）经抗 Ｔ 单抗治疗后有效 ６６ 例（６８０４％ ）。治疗前 Ｃ Ｄ＋４ ／ Ｃ Ｄ＋８ 比值异常者疗效优于本身正常者，治疗后 Ｔ 细胞亚群好转者疗效优于未好转者，治疗后 Ｈ Ｌ Ａ Ｄ Ｒ 抗原表达降低者疗效相对高于未降低者，重症型疗效低于慢性型；治疗前病程越长疗效越差；重复治疗不仅安全而且有效，但疗效与初次治疗反应有关，初治无效者重复治疗效果也差；单抗治疗后多在 ６ 个月内起效，随随访时间的延长疗效略有下降，病毒所致再障疗效相对较差，性别和年龄与疗效无关，３ 种治疗方案之间疗效差异无显著性。本结果为合理选用抗 Ｔ 单抗治疗提供了依据。Ninety seven cases with aplastic anemia(SAA Ⅰ 21,SAA Ⅱ 34,CAA 42)had received McAb CD 3 and/or McAb CD 8 and got effective rate 68.04% In order to find out effect related factors of that therapy, multi factor analysis was carried out. The results showed:1.Effective rate of patients with abnomal CD + 4/CD + 8 ratio at pre treatment was higher than that of patients with nomal CD + 3/CD + 8 ratio, and improvement of CD + 3/CD + 8 ratio after treatment were followed positive reaction. Patients with decreased HLA DR after treatment got relative higher effective rate than those without decreased (72.97% vs 57.71%,P>0.05). 2. Effective rate in SAA was lower than that in CAA. 3.Course of disease interrelated to effective rate, the longer the course was, the lower the effective rate. 4. Repeated courses were not only safe but also effective in most cases, especially in patients with positive reaction to their first courses. 5.Cause of disease was not a effect related factor, but virus induced cases benefited relatively less from that therapy. 5.Neither had sex nor age of patients related to effective rate, and three different protocols had not induced signifficant different results. These protocols had not induced signifficant different results. These results would give help to decide when and who should receive that therapy.

关 键 词：再生障碍性贫血 单克隆抗体 治疗 疗效 

分 类 号：R556.505[医药卫生—血液循环系统疾病]