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严重再生障碍性贫血(SAA)的发病机理与治疗仍有争议,为评述免疫抑制(IS)治疗 SAA 对生存期的影响,欧洲骨髓移植组(EGBMT)收集来自4个治疗中心共14个协作组的170例 SAA。将 IS 分成3类进行治疗比较:①单用抗胸腺球蛋白(ATG);③ATG和输注单倍体相符的亲属骨髓;③高剂量6-甲基强的松龙丸(b-6Mepr)。生存期从 IS 的第1天算起,1年的实际生存期为62.7%(86例),2年为56%,4年为52%。各治疗中心的生存期无显著差异。病因分析中,特发性117例,药物因素26例,肝炎后16例,苯引起2例,体质性2例及各种因素7例。IS 之前有97%病例曾应用雄性激素和小剂量类固醇治疗无效。
The pathogenesis and treatment of severe aplastic anemia (SAA) remain controversial. To review the impact of immunosuppressive therapy (SAA) on survival, the European Marrow Transplant Group (EGBMT) collected 14 co-operative groups from 4 treatment centers Of 170 cases of SAA. The IS treatment was divided into three categories: ① anti-thymocyte globulin alone (ATG); ③ ATG and haploidentical infusion matched relatives of bone marrow; ③ high-dose 6-methyl prednisone pills (b-6Mepr). Survival period From the first day of IS, the actual survival at one year was 62.7% (86 cases), 56% at 2 years and 52% at 4 years. The survival of the treatment center no significant difference. Etiological analysis, Idiopathic 117 cases, 26 cases of drug factors, 16 cases of hepatitis, benzene caused 2 cases, 2 cases of constitutional and various factors in 7 cases. Before IS, 97% of the cases had been treated with androgen and low-dose steroids ineffective.