强烈免疫抑制联合脐血支持治疗重型再生障碍性贫血并发感染的临床观察  

Clinical observation of intensive immunosuppression combined with umbilical cord blood support therapy in severe aplastic anemia complicated with infection

作　　者：宋晓晨[1] 周芳[1] 

机构地区：[1]济南军区总医院血液科,250031

出　　处：《白血病．淋巴瘤》2013年第3期172-174,共3页Journal of Leukemia & Lymphoma

摘　　要：目的 了解重型再生障碍性贫血（SAA）患者行强烈免疫抑制联合脐血输注支持治疗中合并感染的临床特征及治疗效果。方法 回顾性分析27例应用抗胸腺细胞球蛋白（ATG）＋环磷酰胺（Cy）＋环孢素A（CsA）免疫抑制联合脐血输注支持治疗的SAA-Ⅰ患者合并感染的患病率、细菌谱及预后。结果 27例患者并发感染的发生率为48.1 %（13例），细菌占70.0 %（7／10例次），以G-杆菌为主，真菌占30.0 %（3／10例次）。上呼吸道是最常见的感染部位，其次是血液和肺部。发生初次感染的中位时间为免疫抑制治疗后9.5 d（-2天至-10天），并且初次感染时ANC多＜0.2×109／L。结论 强烈免疫抑制联合脐血输注治疗SAA-Ⅰ患者已初见疗效，感染发生率低，早期足量应用敏感抗生素可有效控制。Objective To study the clinical characteristics and treatment effect of combination of intensive immunosuppression therapy and umbilical cord blood infusion for severe aplastic anemia（SAA）patients with infection. Methods A retrospective analysis of prevalence of infection occurring in 27 SAA -Ⅰpatients who received antithymocyte globulin （ATG） ＋ cyclophosphamide （Cy） ＋ cyclosporine A （CsA） followed by umbilical cord blood infusion, their bacterial spectrum, and treatment effect. Results The prevalence of infection in 27 SAA -Ⅰpatients was 48.1 % （13/27）, among which 70.0 % （7/10） was infection with bacteria （mostly with gram-negative bacili） and 30.0 % （3/10） with fungal infection. Upper respiratory tract is the most common site of infection, followed by blood and lungs.The primary infection of the median time for immunosuppressive therapy after 9.5 d （from -2 day to -10 day）, and the initial infection of ANC 〈 0.2×109/L. Conclusion Intensive immunosuppression with umbilical cord blood infusion for the treatment of SAA -Ⅰ already saw effect,low infection rate, early full application of sensitive antibiotics can effectively control.

关 键 词：贫血 再生障碍性 免疫抑制治疗 脐血 感染 

分 类 号：R556.5[医药卫生—血液循环系统疾病]