52例非重型再生障碍性贫血患者环孢素A治疗前后生活质量的变化研究

OBJECTIVE: To explore changes in the quality of life（QoL）in patients with non-severe aplastic anemia（NSAA）after 2 years of cyclosporine A（CsA）therapy, and possible factors may affect the QoL. METHODS: Patients with de novo NSAA from January 2014 to 2016 who had been treated with only CsA for at least 2 years in the outpatient department of Peking Union Medical College Hospital were instructed to fill-in the SF-36 form before and after 2 years of CsA treatment. Data from NSAA were compared with those of normal controls; patients' information such as age, sex, education, annual income, type of payment, and compliance were collected, disease severity and response to treatment were also evaluated. RESULTS: A total of 52 patients were included in our study with 27（51.9％）men and 25（48.1％）women, with the medium age of 48（21–85）years. After 2 years of treatment, 15（28.8％）patients achieved complete response（CR）, 25（48.1％）achieved partial response（PR）, and 12（23.1％）patients had no response（NR）. The overall response rate（ORR）was 76.9％. Before the therapy, SF-36 scores in patients with NSAA were significantly lower than that of normal controls either in physical or mental component summaries（P<0.05）. However, after 2 years of therapy, patients with NSAA had significant improvement of mental component summaries and recovered to normal with even higher scores in mental health（MH）（65.9±17.6 vs 59.7±22.9, P＝0.014）and energy/vitality（VT）（58.8±20.1 vs 52.3 ± 20.9, P＝0.023）compared with normal controls, although they still had comparatively lower scores in physical component summaries. No associations were found between QoL and age, sex, educational level, family income, type of payment, patient adherence, or transfusion dependency. Patients with higher ECOG（the Eastern Cooperative Oncology Group score）at the beginning experienced greater progress in QoL compared to those with lower ECOG. Both patients with CR and PR had shown significant improvement in QoL. CONCLUSION: Patients with NSAA had impaired QoL compared with normal patients. CsA treatment can improve the QoL, especially in mental component summaries. Patients can benefit from the treatment regardless of their social status, and patients with lower ECOG at the beginning seem to benefit more from the therapy.