影响再生障碍性贫血患者疗效的相关因素分析  

An Analysis on Relevant Factors Influencing Curative Effect of Patients with Aplastic Anemia

作　　者：张天琰 张鹂[1] 阳梅[1] 陈春平[1] ZHANG Tian-yan;ZHANG Li;YANG Mei;CHEN Chun-ping(Department of Hematology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院血液内科

出　　处：《标记免疫分析与临床》2019年第11期1908-1912,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的分析影响再生障碍性贫血(AA)患者疗效的相关因素。方法选取2017年4月至2019年4月我院收治的AA患者90例为研究对象,依据治疗疗效将其分为观察组、对照组,比较两组临床资料,分析影响其疗效的相关因素。结果 90例患者经免疫抑制剂(主要为环抱菌素A+抗胸腺/淋巴细胞球蛋白)、造血干细胞移植等治疗6~10个月后,有效率为64.44%(58/90);单因素及多因素Logistic回归分析显示,病因为肝炎相关性、7或7q-染色体异常、血流感染、入院时铁过载、T淋巴细胞CD3^+、肿瘤坏死因子-α(TNF-α)、可溶性Fas(sFas)、诊断至移植间期>3个月为AA患者疗效不佳的危险因素,粒细胞集落刺激因子(G-CSF)为保护性因素(P<0.05)。结论再生障碍性贫血患者可能受病因、细胞遗传学、血流感染、入院时铁过载、T淋巴细胞与炎症因子水平、诊断至移植间期时间等因素影响而在免疫抑制剂治疗或造血干细胞移植后疗效不佳,补充G-CSF可能有助于改善患者疗效,应据此开展针对性措施。Objective To analyze relevant factors influencing curative effect of patients with aplastic anemia(AA).Methods A total of 90 AA patients who were admitted to the hospital from April,2017 to April,2019 were enrolled for the study.According to curative effect,they were divided into the observation group and the control group.The clinical data were compared between the two groups.The relevant factors influencing curative effect were analyzed.Results After treatment with immunosuppressive agents(mainly on cyclosporin A,antithymocyte/lymphocyte globulin)and hematopoietic stem cell transplantation for 6~10 months,the response rate was 64.44%(58/90).Univariate and multivariate logistic regression analysis showed that hepatitis correlation was the cause.Also,7 or 7 q-chromosomal abnormalities,bloodstream infection,iron overload at admission,T lymphocyte CD3^+,tumor necrosis factor-α(TNF-α),soluble Fas(sFas),interval from diagnosis to transplantation longer than 3 months were risk factors for poor curative effect in AA patients,while application of granulocyte colony-stimulating factor(G-CSF)was a protective factor(P<0.05).Conclusion AA patients can be affected by factors such as cause of disease,cytogenetics,bloodstream infection,iron overload at admission,levels of T lymphocyte and inflammatory factors,and interval from diagnosis to transplantation to lead to a poor curative effect after immunosuppressive agents treatment or hematopoietic stem cell transplantation.Supplementation of G-CSF could help to improve curative effect of patients.And targeted measures should be taken accordingly.

关 键 词：再生障碍性贫血 疗效 因素 

分 类 号：R73[医药卫生—肿瘤]