摘要
目的:评估含盐酸二甲双胍联合环孢素A方案治疗难治性再生障碍性贫血(AA)患者获得血液学反应的疗效和安全性。方法:入组2020年1月—2021年12月收治的27例难治性AA患者,所有患者在门诊确诊后均接受含盐酸二甲双胍联合环孢素A口服治疗。在接受治疗后1、3、6、12个月进行临床疗效和不良反应评估,评估主要指标包括血红蛋白、中性粒细胞绝对值、血小板计数及输血依赖等,不良反应评估主要包括低血糖反应、肝肾功能评估等。结果:纳入27例难治性AA患者中,男10例,女17例,年龄14~83岁。治疗前后患者血红蛋白、中性粒细胞绝对值、血小板计数的中位数分别为82g/L vs 111g/L、1.48×10^(9)/L vs 1.83×10^(9)/L、34×10^(9)/L vs 46×10^(9)/L,差异有统计学意义(P<0.05)。治疗后1、3、6、12个月评估疗效,分别有19例(70.37%)、20例(74.07%)、22例(81.48%)、24例(88.89%)患者获得血液学反应。用药期间有4例患者出现转氨酶轻度升高,5例患者出现肾功能异常,调整用药方案并加用保肝等药物后恢复正常,所有患者均未出现低血糖反应。结论:初步观察含盐酸二甲双胍联合环孢素A方案治疗难治性AA有效且安全性好,提示含盐酸二甲双胍联合治疗方案可作为潜在的治疗难治性AA的方法之一。
Objective:To evaluate the efficacy and safety of metformin hydrochloride-containing combined with cyclosporine A regimen in patients with refractory aplastic anemia(AA).Methods:Twenty-seven patients with re-fractory AA admitted between January 2020and December 2021were included.All patients received oral treat-ment containing metformin hydrochloride combined with cyclosporine A after outpatient diagnosis.The clinical ef-ficacy and adverse events at 1,3,6,and 12months after receiving treatment were evaluated,with key indicators including hemoglobin,the absolute value of neutrophil,platelets,and transfusion dependence.The assessment of adverse events mainly included hypoglycemic reactions and assessment of liver and kidney function.Results:A mong the 27patients with refractory AA,10males and 17females aged from 14to 83years old.The median he-moglobin,the absolute value of neutrophil,and the platelet count of the patients before and after treatment were 82g/L vs 111g/L,1.48×10^(9)/L vs 1.83×10^(9)/L,34×10^(9)/L vs 46×10^(9)/L,respectively(P<0.05).A fter 1,3,6and 12months of treatment,19cases(70.37%),20cases(74.07%),22cases(81.48%)and 24cases(88.89%)achieved hematological response,respectively.Four patients experienced mild elevation of transamina-ses and five patients experienced renal function abnormalities during the dosing period,which returned to normal after adjustment of the dosing regimen and addition of hepatoprotective and other drugs,and all patients did not experience hypoglycemic reactions.Conclusion:Preliminary observations showed that metformin hydrochloride combined with cyclosporine A regimen was effective and safe in the treatment of refractory AA,suggesting that the metformin hydrochloride combination regimen could be one of the potential treatments for refractory AA.
作者
王紫宁
陈浩然
张钧栋
李泓毅
智鹏
卢学春
WANG Zining;CHEN Haoran;ZHANG Jundong;LI Hongyi;ZHI Peng;LU Xuechun(Medical School of Chinese PLA,Beijing,100853,China;Department of Hematology,the Second Medical Center&National Clinical Research Center for Geriatric Diseases,Chinese PLA General Hospital;Management School,Shanxi Medical University)
出处
《临床血液学杂志》
CAS
2022年第9期663-667,673,共6页
Journal of Clinical Hematology
基金
2019年度保健专项科研课题(No:19BJZ28)。
