改良预处理方案自体移植治疗系统性红斑狼疮疗效评估  

Therapeutic Effect Evaluation about Improved Pretreatment Regimen of Autologous Transplantation of Systemic Lupus Erythematosus

作　　者：胡萌[1] 赵小强[1] 朱冰柯[1] 张艳芝[1] 黄彩娟[1] 杨海平[1] 

机构地区：[1]河南科技大学第一附属医院,河南洛阳471003

出　　处：《中国医学创新》2014年第11期8-10,共3页Medical Innovation of China

摘　　要：目的：研究短疗程大剂量环磷酰胺和依托泊苷、体内去T细胞预处理方案自体移植治疗系统性红斑狼疮的疗效及安全性。方法：入组患者采髓后体外低温保存，预处理方案：环磷酰胺60 mg/kg，依托泊苷10～20 mg/kg，均于移植前的第1、2天应用；骨髓输注后第2～6天应用抗胸腺细胞球蛋白（ATG）3～5 mg/（kg·d）。结果：所有患者均成功实现了造血重建；患者白细胞重建时间8～14 d，中位时间11 d；血小板重建时间12～36 d，中位时间18 d；移植后原有肝肾功能损害逐渐改善，未发生移植相关死亡；移植前后狼疮活动指数、血沉、补体、抗核抗体比较差异有统计学意义（P＜0.05）。结论：应用该方案进行自体移植，安全性好，疗效肯定，适合基层医院开展。Objective：To study the efficacy and safety of pretreatment regimen of high doses CTX and VP-16 combined with vivo T cell removal in autologous transplantation of Systemic Lupus Erythematosus（SLE）. Method：After autologous bone marrow collection,the pretreatment regimen was given. The regimen included cyclophosphamide 60 mg/kg, etoposide 10-20 mg/kg,on the first day and the second day before the transplantation,antithymocyte globulin（ATG） 3-5 mg/（kg·d）,from the second day to the sixth day after bone marrow infusion. Result：All patients successfully achieved hematopoietic reconstruction,the median time of white cells recovered was 11（8-14 ）d,the median time of platelets recovered is 18（12-36）d,no transplant-related death occur;when the lupus activity index,ESR, complement and antinuclear antibodies were compared before and after transplantation,the difference were statistically significant（P〈0.05）. Conclusion：The application of this regimen have good safety,significant treatment effects,is suitable for primary hospitals.

关 键 词：环磷酰胺 依托泊苷 抗胸腺细胞球蛋白 系统性红斑狼疮 

分 类 号：R593.241[医药卫生—内科学]