| 沈文婷,许诣.他克莫司替代治疗环孢素A不耐受的非重型再生障碍性贫血的临床观察[J].安徽医药,2016,20(8):1576-1578. |
| 他克莫司替代治疗环孢素A不耐受的非重型再生障碍性贫血的临床观察 |
| Clinical observation of tacrolimus in the treatment of non severe aplastic anemia in replacement of cyclosporin A |
| 投稿时间：2016-03-10 |
| DOI： |
| 中文关键词: 贫血,再生障碍性 他克莫司 环孢素A 治疗结果 |
| 英文关键词: Anemia,aplastic Tacrolimus Cyclosporine A Treatment outcome |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨他克莫司(FK506)替代治疗环孢素A(CsA)不耐受的非重型再生障碍性贫血(AA)的疗效。方法 选择CsA治疗无效或不耐受的非重型AA患者39例。按血药浓度75∶1的比例将CsA替换为FK506,维持血药浓度在4～6 μg·L-1。治疗后,根据疗效将患者分为A组(CsA无效换用FK506有效)、B组(CsA有效换用FK506仍有效)、C组(CsA无效换用FK506仍无效) 三组。结果 替换治疗后三组患者CsA和FK506血药浓度差异无统计学意义(P＞0.05)。替换FK506后,共有24例患者获得血液改善,有效率为61.54%。治疗后白细胞计数、血小板计数和血红蛋白浓度均显著改善(P＜0.05),但是A、B组差异无统计学意义(P＞0.05)。 替换FK506治疗后,肾功能损害、神经系统损害和齿龈增生得到明显改善(P＜0.05)。结论 FK506替代治疗CsA不耐受的非重型AA可显著改善血液学指标及CsA继发的肾功能损伤的不良反应。FK506可作为CsA的一个替代方案用于AA的治疗。 |
| 英文摘要: |
| Objective To explore the efficacy of tacrolimus (FK506) in the treatment of non severe aplastic anemia in replacement of cyclosporin A(CsA).Methods We selected 39 patients of non severe aplastic anemia the treatment of whom was not effective or not tolerated with CsA.FK506 was in replacement of CsA at 75∶1 drug concentration in blood,that is,4～6 μg·L-1. After treatment,the patients were assigned into group A (CsA ineffectivewhile FK506 effective),group B (CsA and FK506 both effective),C (CsA and FK506 both ineffective).Results There was no significant difference in drug concentration between CsA and FK506 after replacement therapy(P>0.05).After the replacement of FK506,a total of 24 patients was improved with an efficacy rate of 61.54%.After treatment,white blood cell count,platelet count and hemoglobin concentration were significantly improved (P<0.05),but there was no significant difference between group Aand B (P>0.05).After the replacement of FK506,renal function damage,nervous system damage and gingival hyperplasia were improved significantly(P<0.05).Conclusions FK506 replacement therapy of non severe aplastic anemia intolerant of CsA can significantly improve hematologic parameters and secondary renal injury caused by CsA,therefore,it can be used as an alternative to CsA for the treatment of aplastic anemia. |
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