目的 探討鹽酸川芎嗪注射液聯(lián)合環(huán)孢素A治療再生障礙性貧血的臨床療效及其對血清炎癥因子的影響。方法 選取2012年10年—2019年12月北京航天總醫(yī)院收治的95例再生障礙性貧血患者作為研究對象，按照隨機數(shù)字表法將患者分為對照組（47例）和觀察組（48例）。對照組口服環(huán)孢素軟膠囊，劑量3～5 mg/（kg·d），每日分3次口服。觀察組在對照組基礎(chǔ)上靜脈滴注鹽酸川芎嗪注射液，80 mg/次，1次/d，連續(xù)治療2周后休息2周。兩組均連續(xù)治療12周。比較兩組的臨床總有效率，檢測兩組患者治療前后紅細胞計數(shù)、血小板計數(shù)、血紅蛋白（Hb）、白細胞介素（IL）-17、IL-2、_γ-干擾素（IFN）的水平。運用世界衛(wèi)生組織生存質(zhì)量測定量表（WHOQOL-100）測定兩組患者的生活質(zhì)量。記錄兩組出現(xiàn)藥物不良反應(yīng)的情況。結(jié)果 治療后，觀察組總有效率為95.83%，對照組為82.98%，觀察組明顯高于對照組，差異有統(tǒng)計學意義（P<0.05）。兩組治療后的紅細胞計數(shù)、血小板計數(shù)、Hb水平顯著升高（P<0.05）；觀察組治療后的紅細胞計數(shù)、血小板計數(shù)、Hb水平顯著高于對照組，差異有統(tǒng)計學意義（P<0.05）。兩組治療后的IL-17、IL-2、IFN_-γ水平顯著降低（P<0.05），觀察組降低的更明顯（P<0.05）。兩組治療后的WHOQOL-100評分顯著低于治療前（P<0.05）；觀察組的WHOQOL-100評分比對照組低，差異有統(tǒng)計學意義（P<0.05）。兩組不良反應(yīng)的發(fā)生率無明顯差異。結(jié)論 鹽酸川芎嗪注射液聯(lián)合環(huán)孢素A可提高再生障礙性貧血的療效，降低患者血清炎癥因子的水平，改善患者的生活質(zhì)量，且安全性良好，具有良好的臨床運用價值。

Objective To investigate the clinical study of Ligustrazine Hydrochloride Injection combined with cyclosporine A in treatment of aplastic anemia, and its effect on serum inflammatory factors. Methods A total of 95 patients with aplastic anemia admitted to Beijing Aerospace General Hospital from October 2012 to December 2019 were selected as the research objects, and the patients were divided into control group (47 cases) and observation group (48 cases) according to random number table method. Patients in the control group were po administered with Cyclosporin Soft Capsules at a dose of 3 — 5 mg/(kg·d), three times daily. Patients in the observation group were iv administered with Ligustrazine Hydrochloride Injection on the basis of control group, 80 mg/time, once daily, for continuous treatment for 2 weeks and then rest for 2 weeks. Both groups were treated continuously for 12 weeks. The total clinical effective rate of two groups were compared, and the levels of erythrocyte count, platelet count, interleukin (IL) -17, IL-2 and interferon (IFN) _-γ were detected before and after treatment in two groups. The quality of life of the patients in two groups was measured by the World Health Organization Quality of Life Scale (WHOQOL-100). Adverse drug reactions in both groups were recorded. Results After treatment, the total effective rate of the observation group was 95.83%, and that of the control group was 82.98%, the observation group was significantly higher than the control group, the difference was statistically significant (P < 0.05). After treatment, the erythrocyte count, platelet count, and Hb levels in two groups were significantly increased (P < 0.05). After treatment, the erythrocyte count, platelet count, and Hb levels in the observation group were significantly higher than those in the control group, with statistical significance (P < 0.05). After treatment, the levels of IL-17, IL-2, and IFN_-γ in two groups were significantly decreased (P < 0.05), and the decrease was more obvious in the observation group (P < 0.05). The WHOQOL-100 scores of two groups after treatment were significantly lower than those before treatment (P < 0.05). The WHOQOL-100 score of the observation group was lower than that of the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in the incidence of adverse reactions between two groups. Conclusion Ligustrazine Hydrochloride Injection combined with cyclosporin A can improve the curative effect of aplastic anemia, reduce the level of serum inflammatory factors and improve the quality of life of patients, with good safety and good clinical application value.

R973

北京市醫(yī)院管理局”青苗”計劃項目（QML20180503）