重型再生障碍性贫血85例治疗临床观察与分析  

Clinical observation and analysis of 85 patients with severe aplastic anemia

作　　者：周芳[1] 刘希民[1] 孔凡盛[1] 方圆[1] 解琳娜[1] 宋宁霞[1] 余喆[1] 宋晓晨[1] 

机构地区：[1]济南军区总医院血液科,济南250031

出　　处：《临床血液学杂志》2013年第6期786-788,共3页Journal of Clinical Hematology

摘　　要：目的：观察采用异基因造血干细胞移植（Allo-HSCT）以及免疫抑制剂联合脐血输注治疗重型再生障碍性贫血（SAA）的疗效。方法：85例AA患者，有亲属全相合供者首选移植，无亲属全相合供者根据患者具体情况选择强烈免疫抑制剂联合脐血输注治疗或选择非血缘或不全相合移植方案治疗。其中42例SAA患者进行Allo—HSCT，43例SAA或极重型AA患者采用抗胸腺细胞球蛋白2．5～3．0mg／（kg·d）×5d＋环磷酰胺50mg／（kg·d）×2d联合非亲缘脐血输注支持治疗。结果：42例Allo—HSCT患者中，33例明显治愈，1例明显进步，1例无效，7例死亡，有效率为81．0％。43例强烈免疫抑制剂联合脐血输注的患者中，31例基本治愈，2例明显进步，3例无效，7例死亡，有效率为76．7％。总有效率为78．8％。结论：Allo—HSCT及免疫抑制剂联合脐血输注是治疗SAA的有效方法，均可取得满意的疗效。Objective：To evaluate the efficacies of allogenic stem cell transplantation （Allo-HSCT） and immu- no-suppressive therapy with umbilical cord blood transfusion for severe aplastic anemia （SAA）. Method： A total of 42 SAA patients were treated with Allo-HSCT and the other 43 patients with SAA or VSAA received immuno- suppressive therapy combined with umbilical cord blood transfusion. Therapy protocol was ATG 2.5-3.0 rag/（kg . d）× 5 d;CTX 50 mg/（kg . d）× 2 d;CsA maintenance therapy. Result： Among 42 patients treated with Allo HSCT, 33 cases recovered, 1 case improved, 1 case had no response, 7 cases died and the effective rate was 81.0 %. Among 43 patients treated with immuno suppressive combined with umbilical cord blood transfusion therapy, 31 cases recovered, 2 cases improved, 3 cases had no response, 7 cases died and the effective rate was 76.7 %. The total effective rate was 78.8%. Conclusion： Allo HSCT and immuno-suppressive combined with umbilical cord blood transfusion therapy are effective strategies to treat SAA,both of which can achieve satisfactory results.

关 键 词：贫血 重型再生障碍性 脐血 免疫抑制 异基因移植 

分 类 号：R556.5[医药卫生—血液循环系统疾病]