抗胸腺球蛋白联合环孢素A治疗儿童重型再生障碍性贫血9例分析  

Evaluation of combined anti-thymocyte globulin and cyclosporin A therapy in the treatment of severe aplastic anemia in children

作　　者：秦巍[1,2] 陈光福[1,2] 高红英[1,2] 陈娟娟[1,2] 

机构地区：[1]深圳市第二人民医院 [2]深圳大学第一附属医院儿科,广东深圳518035

出　　处：《热带医学杂志》2013年第3期339-341,共3页Journal of Tropical Medicine

摘　　要：目的探讨联合使用抗胸腺球蛋白(ATG)及环孢素A(CSA)治疗儿童重型再生障碍性贫血(SAA)的疗效及影响因素。方法应用ATG联合CSA治疗9例儿童SAA。ATG4～5mg/(kg·d)静脉滴注,CSA起始量为3～5mg/(kg·d),辅以成分血输注、造血生长因子等支持治疗。检测治疗前后外周血象及骨髓象的变化,以流式细胞仪测定治疗前后外周血T淋巴细胞亚群的改变情况。结果随访9例中基本治愈3例,缓解3例,明显进步2例,死亡1例,总有效率为88.89%。治疗后3个月外周血CD4+细胞比例升高,CD8+细胞比例降低,CD4+/CD8+比值升高,与治疗前比较差异有统计学意义(P<0.01)。结论联合使用ATG、CSA作为初诊儿童SAA的首次治疗方案效果良好。Objective To analyze the effectiveness of combined anti-thymocyte globulin （ATG） and cyclosporin A （CSA） therapy in the treatment of children with severe aplastic anemia （SAA）. Methods 9 children with SAA from the Department of Pediatrics, the first affiliated hospital of Shenzhen university, were studied retrospectively. All of them were treated with ATG 4-5 mg/（kg.d） and CSA 3~5 mg/（kg.d）, assisting with G-CSF treatment. Results The complete remission rate was 33.3%, the partial remission rate was 33.3%, and the obvious improvement rate was 22.2%. 1 child died and the overall response rate was 88.89%. The ratio of perpherial blood CD4＋ to CD8＋ T cells was increased at 3 month after treatment （P〈0.01）. Five patients suffered from severe infection and one of these patients was died. One patient got chronic infection and needed transfusion. The other 3 patients were recovered. Conclusion ATG combined with CSA therapy is effective in the treatment of children with SAA.

关 键 词：再生障碍性贫血 抗胸腺球蛋白 环孢素A 儿童 

分 类 号：R556.5[医药卫生—血液循环系统疾病]