摘要
目的观察免疫抑制疗法治疗急慢性再生障碍性贫血(再障)的疗效及其有效低毒剂量范围.方法试验组48例,5例急性再障(AAA)患者给予静脉输注环孢菌素A(CSA)(5～8.5 mg·kg-1·d-1)+大剂量甲基强的松龙(15～25mg·kg-1·d-1),43例慢性再障(CAA)患者口服CSA(5～8.5mg·kg-1·d-1),联合应用雄激素安雄(80mg·d-1).每周监测试验组CSA血药浓度,使其保持在200～400 mg/L的有效范围内.显效后维持有效剂量半年以上,雄激素至少服用1年.对照组15例CAA,服用小剂量CSA(2mg·kg-1·d-1)+安雄(80mg·d-1)+强的松(10mg·d-1).结果治疗组起效时间一般小于2个月,总有效率达87.5%以上.治疗4个月中性粒细胞绝对值较治疗前平均上升2.1×109/L,血小板计数平均上升36×109/L,血红蛋白平均上升37g/L,大多脱离血制品.AAA基本治愈3例.结论给予足量长疗程CSA治疗急慢性再障,是一种有效的、价廉的、值得大力推广的治疗方法.
Objective To investigate the clinical efficacy of immunosuppressive therapy in acute and chronic aplastic anemia （AAA and CAA）, and to decide the low - toxicity effective concentration of cyclosporine A （CSA）. Methods For the 48 trial patients （including 5 AAA and 43 CAA ones）, the dosage of CSA was 5 - 8.5 mg·kg^-1 · d^-1 , while for the control 15 CAA, the dosage was 2 mg·kg^-1 ·d^-1 only. The 5 AAA patients were also given high - dose metrisone （HD - MP, 15 - 25 mg · kg^- 1 · d^- 1 ）. All of the patients were given androgen. The serum CSA concentration in the trial patients was determined weekly to maintain it within the range of 200 - 400 mg/L. The effective dose of CSA was given over 6 months, while androgen was given over 12 months. Results The clinical efficacy was appreciable within 2 months, and the overall effective rate was 87.5%. The average absolute number of granulocytes and platelets increased 2.1 × 10^9/L and 36 × 10^9/L, respectively. The hemoglobin was increased 37 g/L. Most of the trial patients were ridded of blood transfusion, and 3 of the 5 AAA patients got cured. Condusion For aplastic anemia, adequate dosage of CSA and long therapeutic course are needed. The therapy is effective and cheap for aplastic anemia and worthy of wider adoption.
出处
《徐州医学院学报》
CAS
2005年第5期432-434,共3页
Acta Academiae Medicinae Xuzhou
