再生障碍性贫血疹治.pptVIP

Aplast Anemia （再生障碍性贫血） Aplastic Anemia (再生障碍性贫血） Aplastic Anemia is a pancytopenia （全血细胞减少）syndrome appearing as anemia, infection and bleeding by multiple causes that result in decrease or failure of hemopoietic (造血）function of BM. Clinic appearance and classification 　Standuard of diagnosis: １．Pancytopenia ; decreased of reticularcytic absolute value（网织ＲＢＣ绝对计数） ２．Usually unenlargement of liver and spleen 3. Bone marrow hypoproliferation（增生低下) of one site at least or hyperproliferation(增生活跃）with megakaryocyte（巨核细胞） decreased : ４．Increased of non-hematohistiololast（非造血组织细胞） ５．Being excepted other pancytopenia disease ６．Uneffect of usual anti-Aneamia treatment Differential diagnosis 1.Myelodysplastic syndrome(MDS;骨髓增生异常综合症） 　　normoblast（幼稚细胞） in blood picture Morbid hemapoietsis (病态造血） 2.paroxysmal nocturnal hemoglobinuria (PNH;阵发性睡眠性血红蛋白尿） Ham’s test , Rouse test (+) 3.Malignant histiocytosis(恶性组织细胞病） 　jaundice（黄疸）,and enlargement of lymphonodus（淋巴结）, liver and spleen.　　 Abnormal histiocyte（异常组织细胞） in BM 4. Aleukemic leukemia Blast cells (原始细胞）can be found in peripheral blood and/or BM Treatment Principle of treatment 1. got rid of possible pathogeny 2. Classified and united treatment. AAA: immunsuppressive + BMT +cell factor CAA: male hormone mainly. immunosuppressive agent .sos 3. Early diagnosis,early treatment. druge 一. Male hormone: (first selected for CAA) (1) Effect 　　a. directly stimulating renal EPO b. directly stimulating regeneration （增殖）and division（分裂） of stem cells. (2) Side effect: 　a. damage liver: 　b. manly: (3) Dosage（剂量）: 　testosterone propionate（丙酸睾丸酮） 　　　50-100mg im Qd or QOD stanozol （司坦唑；康力龙）2-4mg 　　　　　 　　　　　　　　　　　　po 　tid danozol （哒那唑） 　2.5-5mg 　 　　　　　　　　　　　　po　 tid eff