目的 探讨盐酸川芎嗪注射液联合环孢素A治疗再生障碍性贫血的临床疗效及其对血清炎症因子的影响。方法 选取2012年10年—2019年12月北京航天总医院收治的95例再生障碍性贫血患者作为研究对象，按照随机数字表法将患者分为对照组（47例）和观察组（48例）。对照组口服环孢素软胶囊，剂量3～5 mg/（kg·d），每日分3次口服。观察组在对照组基础上静脉滴注盐酸川芎嗪注射液，80 mg/次，1次/d，连续治疗2周后休息2周。两组均连续治疗12周。比较两组的临床总有效率，检测两组患者治疗前后红细胞计数、血小板计数、血红蛋白（Hb）、白细胞介素（IL）-17、IL-2、_γ-干扰素（IFN）的水平。运用世界卫生组织生存质量测定量表（WHOQOL-100）测定两组患者的生活质量。记录两组出现药物不良反应的情况。结果 治疗后，观察组总有效率为95.83%，对照组为82.98%，观察组明显高于对照组，差异有统计学意义（P<0.05）。两组治疗后的红细胞计数、血小板计数、Hb水平显著升高（P<0.05）；观察组治疗后的红细胞计数、血小板计数、Hb水平显著高于对照组，差异有统计学意义（P<0.05）。两组治疗后的IL-17、IL-2、IFN_-γ水平显著降低（P<0.05），观察组降低的更明显（P<0.05）。两组治疗后的WHOQOL-100评分显著低于治疗前（P<0.05）；观察组的WHOQOL-100评分比对照组低，差异有统计学意义（P<0.05）。两组不良反应的发生率无明显差异。结论 盐酸川芎嗪注射液联合环孢素A可提高再生障碍性贫血的疗效，降低患者血清炎症因子的水平，改善患者的生活质量，且安全性良好，具有良好的临床运用价值。

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

北京市医院管理局”青苗”计划项目（QML20180503）