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目的评价环孢菌素A(CSA)联合去氢甲基睾丸素方案及去氢甲基睾丸素联合再障生血片方案治疗儿童慢性型再生障碍性贫血(CAA)的临床疗效。方法将68例CAA患儿分为研究组和对照组各34例,研究组采用CSA+去氢甲基睾丸素方案治疗;对照组接受再障生血片+去氢甲基睾丸素方案治疗,疗程6个月,观察其临床疗效。结果研究组患儿的基本治愈率、缓解率、明显进步率和无效率分别是41.18%、23.53%、20.59%和14.71%,对照组分别是17.65%、20.59%、23.53%和38.24%,Z=-2.894,P=0.004。治疗后两组外周血白细胞(WBC)、血小板(PLT)和血红蛋白(HGB)与治疗前比较均有明显提高,P=0.000,且研究组WBC、PLT和HGB明显高于对照组,t=2.379、6.145、5.048,P=0.020、0.000、0.000。研究组的显效时间为(61.98±14.540)d,明显短于对照组的(89.75±16.69)d,t=5.311,P=0.000。两组患儿的不良反应症状较轻,多可耐受,减量或对症处理后均可坚持治疗。结论 CSA联合去氢甲基睾丸素治疗儿童CAA起效快、疗效好、不良反应轻,值得临床推广。
Objective To evaluate the clinical efficacy of cyclosporin A (CSA) combined with dehydro-methyl testosterone and demethylation of testosterone in combination with the treatment of children with chronic aplastic anemia (CAA). Methods 68 cases of CAA children were divided into study group and control group of 34 cases, the study group was treated with CSA + dehydrogen methyl testosterone; control group received BKDH + dehydrogen methyl testosterone regimen, treatment 6 Month, observe its clinical efficacy. Results The basic cure rate, remission rate, significant improvement rate and inefficiency rate in the study group were 41.18%, 23.53%, 20.59% and 14.71%, respectively, while those in the control group were 17.65%, 20.59%, 23.53% and 38.24% = -2.894, P = 0.004. After treatment, WBC, PLT and HGB in both groups were significantly higher than those before treatment (P = 0.000), and WBC, PLT and HGB in the study group were significantly higher than those in the control group (t = 2.379 , 6.145, 5.048, P = 0.020, 0.000, 0.000. The effective time of the study group was (61.98 ± 14.540) d, which was significantly shorter than that of the control group (89.75 ± 16.69) d, t = 5.311, P = 0.000. Two groups of children with mild adverse reactions, tolerability, reduction or symptomatic treatment can be insisted on treatment. Conclusion CSA combined with DHT treatment of children with CAA rapid onset, good efficacy, adverse reactions, worthy of clinical promotion.