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目的抗淋巴细胞球蛋白/抗胸腺细胞球蛋白(ALG/ATG)治疗环孢素 A(CsA)、雄激素、中药联合治疗无效或复发非重型再生障碍性贫血(NSAA)5例疗效观察并文献复习。方法选择华中选择科技大学同济医院附属协和医院的5例环孢素 A、雄激素、中药联合治疗6个月以上无效或复发 NSAA 患者,均需依赖输血,换用 ATG/ALG 治疗,随访观察疗效。结果 ATG/ALG 治疗5例 NSAA 患者基本治愈3例,明显进步2例,4例于90 d 内脱离输血,随访无复发及克隆氏病发生。结论对需依赖输血的 NSAA 患者,环孢素 A 治疗无效或复发后应及早换用 ATG/ALG 治疗,以减少输血引起的并发症和防止持续的骨髓免疫损伤。
Objective To observe the curative effect of anti-lymphocyte globulin / anti-thymocyte globulin (ALG / ATG) on CsA, androgen and traditional Chinese medicine in the treatment of 5 cases of ineffective or recurrent non-severe aplastic anemia (NSAA) review. Methods Select 5 cases of cyclosporin A and androgen combined with traditional Chinese medicine in Union Hospital of Tongji Hospital of Tongji Hospital of Huazhong University of Science and Technology to treat ineffective or recurrent NSAA patients more than 6 months, all need to rely on blood transfusion for ATG / ALG treatment. . Results In 5 patients with NSAA treated with ATG / ALG, 3 cases were basically cured, 2 cases were significantly improved, 4 cases were separated from blood transfusion within 90 days, and no recurrence and Crohn’s disease were observed. Conclusion For NSAA patients who rely on blood transfusion, cyclosporine A should be treated with ATG / ALG as soon as possible after relapse to reduce the complications caused by blood transfusion and to prevent continuous bone marrow immune injury.