不同方法治疗重型再生障碍性贫血儿童临床不良反应分析(1)
摘 要：目的 探讨HSCT和IST治疗儿童重型再生障碍性贫血的不良反应。方法 回顾性分析2011年10月～2017年11月我院收治的113例SAA及vSAA患儿的临床资料，其中接受HSCT治疗的30例设为HSCT组，接受IST治疗的83例设为IST组，比较两组不良反应发生率，HSCT组内不同供体状态不良反应发生率、IST组内应用p-ALG与r-ATG不良反应发生率。结果 治疗后HSCT组感染发生率(60.00%)总体较IST组(35.92%)高(P<0.05);其中HSCT组疱疹病毒感染发生率(23.33%)较IST组(3.61%)高(P<0.05);两组脓毒血症、肺部感染及真菌感染发生率比较差异无统计学意义(P>0.05);HSCT组中，非MSD治疗与MSD治疗其Ⅰ度aGVHD发生率比较，差异无统计学意义(P>0.05); 非MSD治疗较MSD治疗发生Ⅱ度及以上aGVHD、cGVHD的发生率高(P<0.05);药物应用时主要不良反应为类过敏反应，r-ATG发生率高于p-ALG(P<0.05);药物应用后主要不良反应为血清病样反应，两种药物发生率比较，差异无统计学意义(P>0.05)。结论 感染是SAA治疗中最常见不良反应，HSCT组更易发生，尤其是疱疹病毒感染比例高;HSCT治疗应注意供体选择，减少GVHD发生率;IST组应用r-ATG更易出现类过敏反应，需引起重视。
, 百拇医药
关键词：造血干细胞移植;免疫抑制治疗;移植物抗宿主病;血清病样反应;再生障碍性贫血
中图分类号：R556 文獻标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.015
文章编号：1006-1959(2018)24-0059-04
Abstract：Objective To investigate the adverse reactions of HSCT and IST in the treatment of severe aplastic anemia in children. Methods The clinical data of 113 children with SAA and vSAA admitted to our hospital from October 2011 to November 2017 were retrospectively analyzed. Among them， 30 patients receiving HSCT were assigned to HSCT group， and 83 patients receiving IST treatment were set as IST group. The incidence of adverse reactions in the two groups was compared， the incidence of adverse reactions in different donor states in the HSCT group， and the incidence of adverse reactions in the IST group using p-ALG and r-ATG. Results The incidence of infection in HSCT group after treatment (60.00%) was higher than that in IST group (35.92%) (P<0.05). The incidence of herpesvirus infection in HSCT group (23.33%) was higher than that in IST group (3.61%) (P<0.05). There was no significant difference in the incidence of sepsis， pulmonary infection and fungal infection between the two groups (P>0.05).There was no significant difference in the incidence of grade I aGVHD between the non-MSD group and the MSD group in the HSCT group (P>0.05). The incidence of aGVHD and cGVHD was higher in the non-MSD treatment than in the MSD treatment (P<0.05); the main adverse reactions in drug application were allergic reactions， the incidence of r-ATG was higher than that of p-ALG (P<0.05); the main adverse reaction after drug application was serum-like reaction， the incidence of the two drugs was compared， the difference was not statistically significant (P>0.05). Conclusion Infection is the most common adverse reaction in SAA treatment， HSCT group is more likely to occur， especially herpes virus infection rate; HSCT treatment should pay attention to donor selection， reduce the incidence of GVHD; IST group is more prone to allergic reactions using r-ATG， need to cause pay attention to it., 百拇医药(孔令军 何海龙)
, 百拇医药
关键词：造血干细胞移植;免疫抑制治疗;移植物抗宿主病;血清病样反应;再生障碍性贫血
中图分类号：R556 文獻标识码：A DOI：10.3969/j.issn.1006-1959.2018.24.015
文章编号：1006-1959(2018)24-0059-04
Abstract：Objective To investigate the adverse reactions of HSCT and IST in the treatment of severe aplastic anemia in children. Methods The clinical data of 113 children with SAA and vSAA admitted to our hospital from October 2011 to November 2017 were retrospectively analyzed. Among them， 30 patients receiving HSCT were assigned to HSCT group， and 83 patients receiving IST treatment were set as IST group. The incidence of adverse reactions in the two groups was compared， the incidence of adverse reactions in different donor states in the HSCT group， and the incidence of adverse reactions in the IST group using p-ALG and r-ATG. Results The incidence of infection in HSCT group after treatment (60.00%) was higher than that in IST group (35.92%) (P<0.05). The incidence of herpesvirus infection in HSCT group (23.33%) was higher than that in IST group (3.61%) (P<0.05). There was no significant difference in the incidence of sepsis， pulmonary infection and fungal infection between the two groups (P>0.05).There was no significant difference in the incidence of grade I aGVHD between the non-MSD group and the MSD group in the HSCT group (P>0.05). The incidence of aGVHD and cGVHD was higher in the non-MSD treatment than in the MSD treatment (P<0.05); the main adverse reactions in drug application were allergic reactions， the incidence of r-ATG was higher than that of p-ALG (P<0.05); the main adverse reaction after drug application was serum-like reaction， the incidence of the two drugs was compared， the difference was not statistically significant (P>0.05). Conclusion Infection is the most common adverse reaction in SAA treatment， HSCT group is more likely to occur， especially herpes virus infection rate; HSCT treatment should pay attention to donor selection， reduce the incidence of GVHD; IST group is more prone to allergic reactions using r-ATG， need to cause pay attention to it., 百拇医药(孔令军 何海龙)