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目的 探讨强化免疫抑制治疗儿童再生障碍性贫血 (再障 )的疗效。方法 总结我院 1991～ 1999年儿童再障 31例 ,根据治疗方法不同分 3组对比观察 :基础治疗组 (康力龙、6 5 4 2等 ) ,单用环孢菌素A(CSA)治疗组 ,强化免疫抑制治疗组。结果 基础治疗组、单用CSA组、强化免疫抑制治疗组有效率分别为 2 7 2 7% ,5 7 14% ,76 92 % ;重型再障 (SAA)有效率分别为 11 11% ,5 0 0 0 % ,75 0 0 % ;SAA Ⅰ有效率分别为 14 2 9% ,6 0 0 0 % ,88 89%。单用CSA组及强化免疫抑制治疗组疗效明显优于基础治疗组 ,强化免疫抑制组对SAA及SAA Ⅰ疗效更佳 ,有效率分别达 75 0 0 %和 88 89%。结论 以CSA为主的免疫抑制治疗比单用康力龙、6 5 4 2等治疗更有效 ;对于SAA ,CSA联合ALG/ATG、HDIVIG、HDMP等强化免疫治疗能提高疗效 ,对SAA Ⅰ更明显。
Objective To investigate the efficacy of intensive immunosuppression in the treatment of children with aplastic anemia (aplastic anemia). Methods A total of 31 children with aplastic anemia in our hospital from 1991 to 1999 were enrolled in this study. According to the different treatment methods, the patients in the basic treatment group (KangLongLong, 6 5 4 2, etc.), cyclosporine A (CSA) Intensive immunosuppressive therapy group. Results The effective rates of basal therapy group, CSA alone group and intensive immunosuppressive therapy group were 27 72%, 5714% and 76 92% respectively. The effective rates of SAA were 11 11% and 50% respectively 0 0% and 75 0 0% respectively. The effective rates of SAA Ⅰ were 14 2 9%, 60 0% and 88 89% respectively. The efficacy of CSA alone and intensive immunosuppressive therapy group was significantly better than that of the basic treatment group, and the patients with intensive immunosuppression group had better effect on SAA and SAA Ⅰ, the effective rates were 75 0% and 88 89% respectively. Conclusions CSA-based immunosuppressive therapy is more effective than single-dose therapy such as Condone and 6 5 4 2. Intensive immunotherapy with SAA, CSA combined with ALG / ATG, HDIVIG and HDMP can improve the efficacy of SAA Ⅰ.