中剂量环磷酰胺治疗重型再生障碍性贫血的临床研究

摘要

Objectiye:To explore the efficacy and adverse reactions of intermediate-dose cyclophosphamide(ID-CTX)in the treatment of patients with severe aplastic anemia(SAA). Method:Forty patients with SAA were treated in the hospital from June,2009 to December,2012. They were divided into two groups randomly. Twenty patients with SAA were treated with ID-CTX(CTX 20 mg·kg - 1 ·d - 1 )for 4 days,combined with CSA + Androgen. Twenty patients in the control group were treated with CSA + Androgen only. Results:Sixteen of 20 patients treated with ID-CTX regimen were effec-tive,the total efficacy rate was 80. 0% . While in the control group,10 of the 20 patients were effective,the total efficacy rate was 50. 0% . The efficacy rate of the treatment group was significantly higher than that of the control group( <0. 05);the adverse reactions of ID-CTX treatment group was slightly more than the control group,but no significant differ-ence was found between treatment-related mortality. Conclusion:The regimen of ID-CTX combined with CSA + Androgen has significantly higher efficacy rate,less side effects than the treatment regimen of CSA + Androgen.%目的：探讨中剂量环磷酰胺治疗重型再生障碍性贫血患者的疗效及不良反应。方法：40例重型再生障碍性贫血患者随机分为两组，治疗组20例采用中剂量 CTX 20 mg·kg -1·d -1连用4天，联合 CSA +雄激素治疗；对照组20例采用 CSA +雄激素治疗。结果：治疗组16例有效，总有效率80.0%；对照组10例有效，总有效率50.0%。治疗组疗效明显优于对照组，两组比较差异有显著性（<0.05）；环磷酰胺治疗组的轻微不良反应稍多于对照组，但治疗相关死亡率无明显差异。结论：中剂量环磷酰胺联合 CSA +雄激素治疗重型再生障碍性贫血的疗效明显优于 CSA +雄激素，且不良反应小。