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作者用抗淋巴细胞球蛋白(ALG)和大剂量甲基泼尼松龙(HDMP)治疗23例重型再生障碍性贫血患者(其中1例因有合适供者而接受同基因骨髓移植)。23例中男12例,女11例,年龄14～73岁。患者静滴ALG(马免疫球蛋白,瑞士制造)50mg/kg/天,连用5天;为预防药物反应,用药前分别口服扑尔敏4mgq8h、扑热息痛0.5 q6h;每次静滴ALG之前,先静滴甲基泼尼松龙(Methylprednisolone)500mg,30多分钟滴完。第6～30天口服强的松30mg/日。按所用ALG的两种不同批号将患者分为两组,第1组8例、第2组15例。有效病例:临床症状消失、血小板数稳定>40×10~9/L、粒细胞绝对计数>1×10~9/L、不需再输红细胞;完全缓解(CR);血小板数>150×10~9/L、粒细胞绝对计数>2.5×10~9/L、血红蛋白稳定在>120g/L。1例早期死亡者未作疗效分析,但对其生存期和毒性仍加以分析。
The authors treated 23 patients with severe aplastic anemia with anti-lymphocyte globulin (ALG) and high-dose methylprednisolone (HDMP), one of whom received an allogenic bone marrow transplant due to a suitable donor. 23 cases of male 12 cases, 11 females, aged 14 to 73 years. Patients were given intravenous ALG (horse immunoglobulin, Swiss made) at 50 mg / kg / day for 5 days. To prevent drug reactions, chlorpheniramine 4 mg q8h and paracetamol 0.5 q6h were given before oral administration. Before each intravenous infusion of ALG, Methylprednisolone 500mg drops over 30 minutes. 6 ~ 30 days oral prednisone 30mg / day. The patients were divided into two groups according to the two different batches of ALG used, 8 in group 1 and 15 in group 2. Effective cases: disappearance of clinical symptoms, stable platelet count> 40 × 10 ~ 9 / L, absolute granulocyte count> 1 × 10 ~ 9 / L, no need to lose red blood cells; complete remission ~ 9 / L, absolute neutrophil count> 2.5 × 10 ~ 9 / L, and hemoglobin was stable at> 120g / L. One case of early death was not analyzed for efficacy but its survival and toxicity were still analyzed.