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为分析雄激素治疗儿童获得性非重型再生障碍性贫血(non-severe aplastic anemia,NSAA)的疗效,本研究回顾性分析1996年1月-2009年1月在我院治疗的114例NSAA患儿临床资料。所有患儿均接受了康力龙0.1mg/(kg.d)治疗。结果表明,15例(13.2%)患儿在中位时间12个月(2-72个月)获得了完全缓解;6例(5.3%)患儿在中位时间19个月(6-72个月)进展为重型再生障碍性贫血(SAA);其余93例患者(81.6%)仍处于NSAA状态。分析各因素(包括性别、年龄、诊断初期中性粒细胞绝对值(ANC)、网织红细胞绝对(ARC)、血红蛋白,骨髓涂片中粒系/红系比例以及是否有输血依赖)与预后的关系发现,诊断初期伴输血依赖较无输血依赖患者更易进展为SAA(19.2%vs1.1%),两组间差异有统计学意义(p=0.016);诊断初期ARC低于50×109/L或ANC低于0.8×109/L易进展为SAA(8.1%vs0%)(p=0.029);(9.1%vs1.7%)(p=0.034),两者均低的患者更易进展为SAA(12.8%vs1.3%)(p=0.011)。结论 :给予康力龙治疗的NSAA患者有5.3%进展为SAA;诊断初期ARC最低值低于50×109/L和/或ANC最低值低于0.8×109/L的患者或初诊时有输血依赖的NSAA患者更易进展为SAA。
To analyze the efficacy of androgen therapy in children with acquired non-severe aplastic anemia (NSAA), this study retrospectively analyzed 114 children with NSAA treated in our hospital from January 1996 to January 2009 clinical information. All children received Conrol 0.1mg / (kg.d) treatment. Results showed complete remission in 15 (13.2%) children at a median time of 12 months (2-72 months); in 6 (5.3%) children at a median of 19 months (range, 6-72 Month) progressed to severe aplastic anemia (SAA); the remaining 93 patients (81.6%) were still in NSAA status. Factors such as gender, age, absolute neutrophil (ANC), reticulocyte absolute (ARC), hemoglobin, myeloid / erythroid ratio in bone marrow smear, and transfusion-dependent ratio were analyzed and prognostic It was found that SAA (19.2% vs 1.1%) was more likely to be transfused in the early stage of diagnosis compared with those without transfusion dependence, with a significant difference between the two groups (p = 0.016). ARC was lower than 50 × 109 / L in the early stage of diagnosis Or SAA (8.1% vs0%) (9.1% vs1.7%) (p = 0.034), with a lower ANC than 0.8 × 109 / L, both of whom were more likely to progress to SAA 12.8% vs 1.3%) (p = 0.011). CONCLUSIONS: 5.3% of patients with NSAA who had been treated with hyaluronate developed SAA; patients with a minimum ARC below 50 × 109 / L and / or ANC below 0.8 × 109 / L at initial diagnosis or a transfusion-dependent NSAA Patients are more likely to progress to SAA.