免疫抑制治疗成人非重型再生障碍性贫血的疗效及预后分析

摘要

Objective:To explore the clinical efficacy of immunosuppression therapy (IST) on non-severe aplastic anamia (NSAA) adult patients.Methods:51 adult patients with NSAA treated in our hospital from September 2006 to September 2013 were selected and divided into the immunosuppressive therapy (IST) group (n =37) and non-IST group (n =14).The response rate and 5-year survival rate were compared between the two groups.The factors influencing the 5-year survival rate were analyzed by univariate analysis and multiple logistic regression analysis.Results:The total response rate and 5-year survival rate in the IST group were 70.3％ and 76.1％ respectively,which were significantly higher than those in the non-IST group (14.3％ and 37.9％) (P ＜0.05).In IST group,the 5-year survival rate was 81.2％ after over one-year treatment,and was 66.8％ after ≤1 year treatment (P ＜0.05).The 5-year survival rates were 33.3％ and 73.5％ respectively in patients with hepatitis and without (P ＜0.05).Multiple logistic regression analysis showed that the IST was a protective factor for the prognosis of NSAA patients (P ＜0.05).Conclusion:IST was effective in the treatment of NSAA,and patients with over one year treatment had better prognosis.%目的:探讨免疫抑制(IST)治疗成人非重型再生障碍性贫血(NSAA)的疗效及对患者预后的影响.方法:回顾性分析2006年9月至2013年9月广西医科大学第一附属医院血液科收治的51例成人NSAA患者的临床资料,按照治疗方式的不同将患者分为IST治疗组(TST组,37例)和非IST治疗组(NIST组,14例).比较两组患者的治疗总有效率及5年生存率,并采用单因素及多因素Logistic回归分析法对影响患者5年生存率的因素进行分析.结果:IST组治疗总有效率为70.3％,显著高于NIST组的14.3％(P＜0.05).IST组和NIST组的5年生存率分别为76.1％和37.9％(P＜0.05).IST组中,治疗疗程超过1年和不足1年的5年生存率分别为81.2％和66.8％(P＜0.05);合并与不合并肝炎者5年生存率分别为33.3％和73.5％(P＜0.05).多因素Logistic回归分析结果表明,IST治疗是NSAA患者预后的保护因素(P＜0.05).结论:对于成人NSAA患者采用IST治疗的临床疗效尚可,且疗程超过1年的患者预后较佳.