摘要
目的:观察艾曲泊帕联合他克莫司对难治性再生障碍性贫血(Refractory aplastic anemia,rAA)的临床疗效。方法:选取2022年1月至2024年6月期间本院收治的64例rAA患者,随机分为对照组和联合组(n=32)。对照组口服他克莫司胶囊,初始剂量1 mg,bid,后续调整用药剂量使血药浓度维持在4~6μg·L^(-1);联合组加口服艾曲泊帕,剂量75 mg,qd。治疗1 m后比较两组的临床疗效、不良反应发生率;并采用流式细胞仪测定CD4^(+)T细胞(Cluster of differentiation 4 positive,CD4^(+))、CD8^(+)T细胞(Cluster of differentiation 8 positive,CD8^(+))、CD4^(+)/CD8^(+)水平;采用酶联免疫吸附法测定白细胞介素(Interleukin,IL)-6、C反应蛋白(C-reactive protein,CRP)。结果:联合组的临床治疗总有效率显著高于对照组(P<0.05)。治疗后,两组的CD4^(+)、CD4^(+)/CD8^(+)均比治疗前显著升高,CD8^(+)水平均比治疗前显著降低,且联合组的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)的变化幅度均显著大于对照组(P<0.05)。治疗后,两组的IL-6、CRP水平均比治疗前显著降低,且联合组的IL-6、CRP水平均比对照组显著降低(P<0.05)。两组不良反应发生率无显著差异(P>0.05)。结论:艾曲泊帕联合他克莫司治疗rAA,能提高临床疗效,增强患者免疫功能,减轻炎症反应,且安全性较好。
Objective:To observe the clinical efficacy of eltrombopag combined with tacrolimus in refractory aplastic anemia(rAA).Methods:Sixty-four rAA patients admitted to our hospital between January 2022 and June 2024 were selected and randomly divided into the control group and the combined group(n=32).In the control group,tacrolimus capsules were administered orally at an initial dose of 1 mg,bid,and the dose was subsequently adjusted to maintain the blood concentration at 4~6μg·L^(-1);in the combination group,eltrombopag was administered orally at a dose of 75 mg,qd.After one month of treatment,the clinical efficacy and incidence of adverse reactions were compared between the two groups;and differentiation 4 positive,(CD4^(+)),cluster of differentiation 8 positive,(CD8^(+))were measured by flow cytometry,CD4^(+)/CD8^(+)levels,interleukin(IL)-6 and C-reactive protein(CRP)were measured by enzyme-linked immunosorbent assay.Results:The total effective rate of clinical treatment in the combined group was significantly higher than that in the control group(P<0.05).After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)in both groups were significantly increased compared with those before treatment,and the level of CD8^(+)was significantly decreased compared with that before treatment.Moreover,the change amplitudes of CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)in the combined group were significantly greater than those in the control group(P<0.05).After treatment,the levels of IL-6 and CRP in both groups were significantly lower than those before treatment,and the levels of IL-6 and CRP in the combined group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Eltrombopag combined with tacrolimus in the treatment of rAA can improve the clinical efficacy,enhance the immune function of patients,reduce the inflammatory response,and has good safety.
作者
冯佳楠
马彩翼
杨晓亭
Feng Jia-nan;Ma Cai-yi;Yang Xiao-ting(Department of Hematology,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China)
关键词
艾曲泊帕
他克莫司
难治性再生障碍性贫血
Eltrombopa
Tacrolimus
Refractory aplastic anemia
Therapeutic effect
