重型再生障碍性贫血抗胸腺球蛋白治疗后伴垂体功能减退治疗研究探究-新.pdfVIP

·药物警戒· 重型再生障碍性贫血抗胸腺球蛋白治疗后伴垂体功能减退治疗研究 陈智1 2 2* ，戴铁颖 ，林圣云 (1.浙江中医药大学第一临床医学院，杭州 310006 ；2.浙江省中医院 国家中医临床研究(血液病)基地，杭州 310006) 摘要：目的 了解在使用ATG 行强化免疫抑制治疗重型再障的过程中引起垂体功能减退的原因及相关并发症的防治。方法 临床医师总结 1 例应用ATG 引起垂体功能减退的诊治过程及对国内外文献进行查阅。结果 ATG 可以引起垂体功能减退， 应引起临床注意。结论 在临床诊治重型再生障碍性贫血时，要特别注意潜在的并发症，从而降低治疗风险，提高疗效。 关键词：重型再生障碍性贫血；抗胸腺细胞球蛋白；垂体功能减退 中图分类号：R973.3 文献标志码：A 文章编号：1007-7693(2013)05-0544-04 Case Report and Review: Hypopituitarism after the ATG Treatment for the Patient of Severe Aplastic Anemia 1 2 2* CHEN Zhi , DAI Tieying , LIN Shengyun (1.The First Clinical College of Zhejiang Chinese Medicine University, Hangzhou 310006, China; 2.Zhejiang Provincial Hospital of Traditional Chinese Medicine, the National Chinese Medicine Clinical Research (Hematology) Base, Hangzhou 310006, China) ABSTRACT: OBJECTIVE To find out the cause of hypopituitarism induced by ATG in the process of intensive immunosuppressive therapy (IST) for severe aplastic anemia, and to prevent related complications. METHODS A case of hypopituitarism induced by ATG was chosen, which clinical physician participated in the whole treatment and literatures were reviewed. RESULTS ATG can induce hypopituitarism, which should bring enough attentions in clinical. CONCLUSION In the clinical diagnosis and treatment of severe aplastic anemia, we should pay more attention to the potential complications, so as to reduce the risk of treatment, improve the outcome of treatment. KEY WORDS: aplastic anemia; ATG; hypopituitarism 重型再生障碍性贫血(SAA) 是由多种原因所 性粒细胞降低和淋巴细胞降低，⑤免疫过度抑制 致的骨髓造血机能严重不足或衰竭的疾病，较慢 相关的反应，包括感染性合并症(细菌、真菌、病 性再生障碍性贫血起病急，且病情进展迅速，贫 毒及原虫类) ；⑥罕见恶性病，特别是淋巴细胞增 血、出血、感染在就诊时已十分严重，自然病程 1 生症。但ATG 治疗后出现垂体功能减退在国内外 年生存