强化免疫抑制治疗儿童再生障碍性贫血疗效分析

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、654-2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27.27％，57.14％,76.92％；重型再障(SAA)有效率分别为11.11％,50.00％,75.00％;SAA-Ⅰ有效率分别为14.29％，60.00％,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75.00％和88.89％。结论以CSA为主的免疫抑制治疗比单用康力龙、654-2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。

Treatment of aplasticanemia with intensive immunosuppressive agents in children

Objective To investigate the therapeutic effects of intensiveimmunosuppressive agents on aplastic anemia in children. Methods Thirty-one cases of aplastic anemia in children from 1991～1999 in our hospital were divided into three groups according to different treatment:Group A with fundamental therapy, such as stanzolol,654-2, etc.; Group B with cyclosporin A ( CSA ) and Group C with intensive immunosuppressive agents. Results The response rate of Group A,B,C was 27.27% ,57.14% and 76. 92% respectively. It was 11.11% ,50. 00% and 75.00% in SAA and 14.29%,60.00% and 88.89% in SAA- Ⅰ respectively. It was much more effective with therapy of CSA and intensive immunosuppressive agents than with fundamental therapy. The response rate of intensive immunosuppressive agents in SAA and SAA- Ⅰ was even higher. Conclusions It is more effective with immunosuppressive agents on the base of CSA than with fundamental therapy in treating aplastic anemia in children. CSA combined with ALG/ATG, HDIVIG and HDMP can increase the response rate in SAA, especially SAA- Ⅰ patients.