【摘要】 目的评估环孢素A(CsA)、糖皮质激素(CS)治疗成人获得性纯红细胞再生障碍(PRCA)疗效。方法回顾性分析2009年10月至2017年4月南京医科大学第一附属医院收治的42例PRCA接受CsA(16例)、CS(13例)、CsA联合CS(6例)及其他免疫抑制剂(4例)治疗临床资料。结果接受CsA、CS、CsA联合CS及其他免疫抑制剂初始有效率分别为75.0%,46.2%,66.7%,75.0%(P=0.456),累积有效率分别为69.6%(16/23),50.0%(7/14),71.4%(5/7),42.9%(6/14)(P=0.376),累积完全缓解(CR)率分别为26.1%(6/23),28.6%(4/14),57.1%(4/7),14.3%(2/14)(P=0.284)。27例难治复发PRCA,17例改为CsA或CS方案中11例(64.7%)有效,10例改为其他免疫抑制剂3例有效(30%)(P=0.120)。结论 CsA和CS治疗PRCA疗效相似。难治复发PRCA患者,CsA和(或)CS无效后尚无满意的治疗方法。更多还原

【Abstract】 Objective To assess the effect of cyclosporine A(CsA) and corticosteroids(CS) in the treatment of adult patients with acquired pure red cell aplasia(PRCA).Methods Clinical data of 42 cases receiving cyclosporine A(CsA),and/or corticosteroids(CS),or other immunosuppressive agents were retrospectively analyzed,including CsA(n=16),CS(n=13),CsA in combination with CS(n=6),or other immunosuppressive agents(n=4).Results The initial response rates were similar among these patients(75.0%,46.2%,66.7%,75.0%,P =0.456).The cumulative response rates in patients receiving CsA,CS,CsA in combination with CS,or other immunosuppressive agents were 69.6%(16/23),50.0%(7/14),71.4%(5/7),42.9%(6/14),respectively(P =0.376);the cumulative rates of CR were 26.1%(6/23),28.6%(4/14),57.1%(4/7),14.3%(2/14),respectively(P=0.284).In 27 refractory and relapsed PRCA patients,11 out of 17 patients(64.7%) achieved remission by CsA and/or CS regimen,while 3 of 10 patients(30.0%) responded to other immunosuppressive agents(P=0.120).Conclusion CsA and/or CS are similarly effective in treating PRCA.For patients with relapse or refractory PRCA,there are no satisfactory treatments if CsA and/or CS fail.更多还原