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作者报道采用氨甲喋呤(MTX)治疗两例对常用免疫抑制剂耐药的纯红细胞再生障碍性贫血(PRCA).例1,46岁,女性,日本人,因严重贫血住院.体检脸色苍白,无淋巴结或肝脾肿大.血红蛋白(Hb)6.2g/dl,红细胞数1.56×10~(12)/L,白细胞数3.5×10~9/L,血小板数(BPC)359×10~9/L,网织红细胞(Ret)9.4×10~9/L,肝肾功能正常.X线和CT检查无纵膈包块.骨髓示有核细胞增生正常,红系增生减低,粒系和巨核细胞系正常.骨髓红系爆式集落形成单位(BFU-E)35士6/2×10~5单个核细胞,红系祖细胞(CFU-E)50±6/1/2×10~5单个核细胞,诊断为PRCA,先后经用强的松龙(30mg/天)、大剂量甲基强的松龙(1000mg/
The authors report the use of methotrexate (MTX) in two cases of pure erythrocyte aplastic anemia (PRCA) resistant to commonly used immunosuppressants, such as hospitalized patients aged 1,4 years, women and Japanese, suffering from severe anemia, a pale face with no lymph nodes Or hepatosplenomegaly.Hb was 6.2g / dl, the number of red blood cells was 1.56 × 10-12 / L, the number of white blood cells was 3.5 × 10-9 / L, the number of platelets was 359 × 10-9 / L, Reticulocyte (Ret) 9.4 × 10 ~ 9 / L, liver and kidney function was normal .X-ray and CT without mediastinal mass. Bone marrow showed normal proliferation of nucleated cells, erythroid hyperplasia decreased, normal granulocyte and megakaryocyte lines Bone marrow erythroid burst colony forming units (BFU-E) 35 ± 6/2 × 10 ~ 5 mononuclear cells, erythroid progenitor cells (CFU-E) 50 ± 6/1/2 × 10 ~ 5 mononuclear cells , Diagnosed as PRCA, followed by prednisolone (30mg / day), high-dose methylprednisolone (1000mg /