他克莫司、十一酸睾酮联合造血生长因子治疗非重型再生障碍性贫血合并感染的临床效果
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摘要
目的研究他克莫司、十一酸睾酮联合造血生长因子治疗非重型再生障碍性贫血(NSAA)合并感染的临床效果。方法选择在我院诊断并治疗的74例NSAA合并感染患者为研究对象,根据治疗方法的不同将其分为对照组(36例)和试验组(38例)。对照组采用他克莫司+十一酸睾酮+抗感染治疗,试验组采用他克莫司+十一酸睾酮+造血生长因子治疗。比较两组患者的治疗效果。结果试验组的治疗总有效率为97.37%,明显高于对照组的83.33%(P<0.05)。干预前,两组的血红蛋白水平、血小板计数、白细胞计数、CD4+、CD8+、CD4+/CD8+降钙素原及超敏C-反应蛋白水平比较,差异不显著(P>0.05)。干预后,两组的血红蛋白水平、血小板计数、白细胞计数、CD4+及CD4+/CD8+明显上升,CD8+明显下降,且试验组优于对照组(P<0.05);干预后,两组降钙素原及超敏C-反应蛋白水平均显著降低,且试验组低于对照组(P<0.05)。结论他克莫司、十一酸睾酮联合造血生长因子治疗NSAA合并感染患者的临床效果显著,可显著改善患者的免疫功能,并能有效控制感染,值得临床推广与应用。
Objective To study the clinical effect of tacrolimus, testosterone undecanoate combined with hematopoietic growth factor in the treatment of non-severe aplastic anemia(NSAA) with infection. Methods A total of 74 patients with NSAA complicated infection diagnosed and treated in our hospital were selected as study objects and divided into control group(36 cases) and experimental group(38 cases) according to the different treatment methods. The control group was treated with tacrolimus+testosterone undecanoate + anti-infective treatment, and the experimental group was treated with tacrolimus testosterone undecanoate + hematopoietic growth factor. The therapeutic effects were compared between the two groups. Results The total effective rate of treatment in the experimental group was 97.37%, which was significantly higher than 83.33% in the control group(P <0.05). Before intervention, there were no significant differences in levels of hemoglobin, platelet count, white blood cell count, CD4+, CD8+, CD4+/CD8+, the levels of procalcitonin and hypersensitive C-reactive protein between the two groups(P>0.05). After intervention, levels of hemoglobin, platelet count, white blood cell count CD4+and CD4+/CD8+in the two groups increased significantly, while CD8+decreased significantly, and those in the experimental group were better than the control group(P <0.05). After intervention, the levels of procalcitonin and hypersensitive C-reactive protein in the two groups decreased significantly, and those in the experimental group were lower than the control group(P<0.05). Conclusion Tacrolimus and testosterone undecanoate combined with hematopoietic growth factor in the treatment of NSAA patients with infection has a significant clinical effect. It can significantly improve the immune function of patients with NSAA complicated infection, and effectively control the infection, which is worthy of clinical promotion and application.
Objective To study the clinical effect of tacrolimus, testosterone undecanoate combined with hematopoietic growth factor in the treatment of non-severe aplastic anemia(NSAA) with infection. Methods A total of 74 patients with NSAA complicated infection diagnosed and treated in our hospital were selected as study objects and divided into control group(36 cases) and experimental group(38 cases) according to the different treatment methods. The control group was treated with tacrolimus+testosterone undecanoate + anti-infective treatment, and the experimental group was treated with tacrolimus testosterone undecanoate + hematopoietic growth factor. The therapeutic effects were compared between the two groups. Results The total effective rate of treatment in the experimental group was 97.37%, which was significantly higher than 83.33% in the control group(P <0.05). Before intervention, there were no significant differences in levels of hemoglobin, platelet count, white blood cell count, CD4+, CD8+, CD4+/CD8+, the levels of procalcitonin and hypersensitive C-reactive protein between the two groups(P>0.05). After intervention, levels of hemoglobin, platelet count, white blood cell count CD4+and CD4+/CD8+in the two groups increased significantly, while CD8+decreased significantly, and those in the experimental group were better than the control group(P <0.05). After intervention, the levels of procalcitonin and hypersensitive C-reactive protein in the two groups decreased significantly, and those in the experimental group were lower than the control group(P<0.05). Conclusion Tacrolimus and testosterone undecanoate combined with hematopoietic growth factor in the treatment of NSAA patients with infection has a significant clinical effect. It can significantly improve the immune function of patients with NSAA complicated infection, and effectively control the infection, which is worthy of clinical promotion and application.
引文
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[9]唐旭东,张姗姗,许勇钢,等.T细胞亚群在重型再生障碍性贫血治疗中的疗效预测价值[J].中医杂志,2013,54(20):1755-1758.
[10]王文松,钱美华,王曼玲,等.再生障碍性贫血与T细胞亚群及调节性T细胞的相关性分析[J].中华全科医学,2016,14(9):1457-1459.
[11]卢双龙,谢晓恬.免疫抑制治疗再生障碍性贫血疗效预测指标研究进展[J].中华实用儿科临床杂志,2017,32(3):235-237.
[2]邓婷,娄世锋.免疫抑制剂治疗再生障碍性贫血的研究进展[J].现代医药卫生,2016,32(11):1688-1690.
[3]陆亚岚,高清平.造血生长因子治疗成人再生障碍性贫血伴严重感染的疗效观察[J].临床和实验医学杂志,2014,13(18):1529-1531.
[4]中华医学会血液学分会红细胞疾病(贫血)学组.再生障碍性贫血诊断与治疗中国专家共识(2017年版)[J].中华血液学杂志,2017,38(1):1-5.
[5]陈文明,黄晓军.血液病学[M].北京:科学出版社,2012:243.
[6]宋宁,袁胜芳,贾伟华.2016年感染性疾病学重要临床进展[J].临床荟萃,2017,32(2):152-159.
[7]聂玲辉,伍志勇,朱晓光,等.重型再生障碍性贫血的研究进展[J].分子影像学杂志,2017,40(1):85-89.
[8]刘真真,何广胜,王秀丽,等.他克莫司替代环孢素治疗非重型再生障碍性贫血28例临床研究[J].中国实用内科杂志,2013,8(5):388-390.
[9]唐旭东,张姗姗,许勇钢,等.T细胞亚群在重型再生障碍性贫血治疗中的疗效预测价值[J].中医杂志,2013,54(20):1755-1758.
[10]王文松,钱美华,王曼玲,等.再生障碍性贫血与T细胞亚群及调节性T细胞的相关性分析[J].中华全科医学,2016,14(9):1457-1459.
[11]卢双龙,谢晓恬.免疫抑制治疗再生障碍性贫血疗效预测指标研究进展[J].中华实用儿科临床杂志,2017,32(3):235-237.