Abstract
目的评估脾切术治疗复发/难治自身免疫性溶血性贫血（AIHA）患者的疗效。方法回顾性分析中国医学科学院血液病医院30例行脾切除术治疗的复发/难治自身免疫性溶血性贫血（AIHA）患者的临床资料，评估手术疗效。结果30例复发/难治AIHA患者中，单纯AIHA 20例（温抗体型13例，温冷双抗体型2例，Coombs阴性AIHA 5例），Evans综合征10例。脾切除术后10~14 d，20例患者可评价疗效，总有效率（ORR）为90%（完全缓解12例，部分缓解6例）。13例患者有长期随访资料，中位随访14（4~156）个月，截至随访终点，除3例Evans综合征患者死亡外（2例无效，1例复发），10例复发/难治AIHA患者术后6个月9例（90%）有效，术后12个月7例（70%）有效，其中3例患者已持续完全缓解3年以上。结论脾切除术作为二线方案治疗复发/难治AIHA近期疗效好，1年远期ORR达到70%，约三分之一患者可维持长期持续缓解。
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