摘要
目的：了解自身免疫性溶血性贫血的临床特征和治疗,以加深对该病的认识。方法：对我院1997-2006年诊断自身免疫性溶血性贫血的临床资料进行回顾性分析。结果：①80例中病因明确者26例（32.5%）,感染性疾病10例（38.7%）,且感染是疾病复发或病情加重最常见的诱因,与药物有关病例3例（12.5%）。②抗体分型与临床预后相关：IgG＋C3型溶血较重,C3型较轻,IgG型介于两者之间;C3型完全缓解率较高。③误诊病例9例（11.2%）。④糖皮质激素加免疫抑制剂治疗或糖皮质激素加大剂量免疫球蛋白治疗优于单用糖皮质激素治疗（P〈0.01）。结论：自身免疫性溶血性贫血抗体分型与临床及预后相关;基础疾病的追查及治疗有重要意义;应重视临床表现及实验室特征以防止误诊病例的发生;糖皮质激素加免疫抑制剂或加用大剂量免疫球蛋白的治疗方法为优。
Objective： To study the clinical characteristics and treatment of autoimmune hemolytic anemia. Method： Clinical and laboratory characteristics of 80 cases with autoimmune hemolytic anemia admitted to our hospital between June 1997 and October 2006 were analyzed retrospectively. Result： （1） Among the 80 patients, causes of 26 patients were clear, in which the infectious disease was the most common. Drug - related cases were worthy of note. autoimmune hemolytic anemia can be the initial manifestation of lymphoproliferative disease and systemic lupus erythematosus, and the follow- up study of the basic disease can be greatly significant to the treatment of autoimmune hemolytic anemia. （2） Hemolysis and prognosis were relate with the type＇of the autoan- tibody. （3）There 9 missed cases. （4）The complete response rate of group of corticosteroid combined with immunosuppressive drugs and group of corticosteroid combined with intravenous immunoglobulin were respectively higher than that of group of corticosteroid （P 〈 0.01）. Conclusion： Prognosis of autoimmune hemolytic anemia are related with the type of the autoantibody. The great significance of the follow - up study and treatment of the basic disease should be realized. The feature of clinical manifestation and laboratory examination should be taken seriously to avoid misdiagnosis. Corticosteroid combined with immunosuppressive drugs or intravenous immunoglobulin can improve the complete response rate.
出处
《内蒙古医学杂志》
2008年第3期307-309,共3页
Inner Mongolia Medical Journal
