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首页> 外文期刊>Journal of International Medical Research >Diagnosis and Treatment of Acquired Aplastic Anaemia in Adults: 142 Cases from a Multicentre, Prospective Cohort Study in Shanghai, China
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Diagnosis and Treatment of Acquired Aplastic Anaemia in Adults: 142 Cases from a Multicentre, Prospective Cohort Study in Shanghai, China

机译：成人获得性再生障碍性贫血的诊断和治疗：来自中国上海的多中心前瞻性队列研究中的142例病例

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摘要

To improve diagnosis and therapy for aplastic anaemia (AA) in Shanghai, clinical and laboratory data for patients with AA (n = 142) and hypocellular myelodysplastic syndrome (MDS; n = 22) were comparatively analysed (follow-up 2–6 years). Red blood cell distribution width and absolute lymphocyte and reticulocyte counts were significantly different between the two groups. AA was diagnosed in 54.2% of patients using a single bone marrow aspirate smear plus peripheral haemogram results, and in 95.1% using an additional bone marrow biopsy; 4.9% required multiple-site bone marrow examination. Clonal chromosomal abnormalities occurred in 3.9% and 31.8% of patients with AA and MDS, respectively. In patients with severe AA, 12.0% received antithymocyte globulin (ATG) + cyclosporin A (CSA; effectiveness rate 77.8%; 5-year survival 74.1%), 45.3% received CSA + androgen therapy (effectiveness rate 58.8%; 5-year survival 76.5%) and 26.7% received androgen monotherapy (effectiveness rate 25.0%). Multivariate analysis of prognostic factors indicated that therapy regimen and blood platelet count affected survival. Peripheral blood smears, bone marrow spicule classification and biopsy are important diagnostic factors. Standardization of evidence-based therapy and promotion of ATG + CSA would improve general therapeutic effects in AA.
机译：为了改善上海的再生障碍性贫血（AA）的诊断和治疗，对AA（n = 142）和低细胞性骨髓增生异常综合征（MDS; n = 22）的患者的临床和实验室数据进行了比较分析（随访2至6年） 。两组之间的红细胞分布宽度以及绝对淋巴细胞和网织红细胞计数显着不同。使用单次骨髓穿刺涂片检查和外周血涂片检查结果可诊断出54.2％的患者患有AA，另外进行了骨髓活检则诊断为95.1％。 4.9％的患者需要进行多部位骨髓检查。 AA和MDS患者的克隆染色体异常分别发生在3.9％和31.8％。重症AA患者中12.0％接受抗胸腺细胞球蛋白（ATG）+环孢菌素A（CSA;有效率77.8％; 5年生存率74.1％），45.3％接受CSA +雄激素治疗（有效率58.8％; 5年生存率） 76.5％）和26.7％接受了雄激素单药治疗（有效率为25.0％）。预后因素的多变量分析表明治疗方案和血小板计数影响生存。外周血涂片检查，骨髓针分类和活检是重要的诊断因素。循证治疗的标准化和ATG + CSA的推广将改善AA的一般治疗效果。

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