异基因造血干细胞移植患者人类疱疹病毒7型感染  

Human herpesvirus 7 infection in patients after allogeneic hematopoietic stem cell transplantion

作　　者：王立茹[1] 董陆佳[1] 陆道培[1] 

机构地区：[1]北京大学人民医院

出　　处：《中华医学杂志》2007年第30期2113-2116,共4页National Medical Journal of China

摘　　要：目的了解人类疱疹病毒7型(HHV-7)在异基因造血干细胞移植(allo-HSCT)患者的感染现状。方法采集72例 allo-HSCT 患者外周血标本680份以及53例供者标本。采用巢式聚合酶链反应检测供者以及移植前、后患者 HHV-7 DNA 血症。结果 72例患者中有62例(86.1%)移植后至少1次检出 HHV-7 DNA 血症,中位时间为15.6(7～56)d。29例(40.3%)移植后出现持续性HHV-7 DNA 血症。47例接受含抗胸腺细胞球蛋白(ATG)预处理方案的人类白细胞抗原(HLA)配型不合移植或配型相合的非血缘移植患者中持续性 HHV-7血症的发生率为48.9%(23/47),显著高于接受不含 ATG 预处理方案的配型相合移植患者[24%(6/25),P=0.040]。应用糖皮质激素治疗的患者移植后持续性 HHV-7 DNA 血症的发生率为44.6%(39/65),显著高于未接受糖皮质激素治疗的患者[0%(0/7),P=0.037]。HHV-7血症与急性移植物抗宿主病、出血性膀胱炎、巨细胞病毒和人类疱疹病毒6型感染无显著相关性。结论 HHV-7感染在 allo-HSCT 后患者中很常见,且其持续感染与预处理方案中 ATG 和移植后糖皮质激素的应用密切相关。Objective To study the prevalence of human herpesvirus 7 （HHV-7） infection in recipients following allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods Peripheral blood samples were collected before and weekly after allo-HSCT from 72 consecutive recipients and 53 donors. Nested polymerase chain reaction （nPCR） was used to monitor HHV-7 DNAemia. Results HHV- 7 DNAemia was detected at least once in 86.1% （62/72） of the 72 patients on the median day 15.6 （7 56 days） after allo-HSCT. Continuing HHV-7 DNAemia （HHV-7 DNAemia maintained at least 4 weeks） was evidenced in 40.3% （29/72） of the patients after allo-HSCT. The prevalence of continuing HHV-7 DNAemia in the patients receiving HLA mismatched or HLA matched unrelated allo-HSCT who underwent conditioning with anti-thymocyte globulin （ATG） was 48.9% （ 23/47 ）, significantly higher than that in the patients receiving HLA matched related allo-HSCT with conditioning without ATG [ 24% （6/25）, P = 0.040 ]. Enhanced incidence the prevalence of HHV-7 DNAemia in the patients receiving corticosteriod after allo-HSCT was 44. 6% （39/65）, significantly higher than that in the patients who did not receive corticosteriod [ 0% （0/7）, P = 0. 037 ]. No relationship was observed between HHV-7 infection and transplant-related complications including acute graft versus host disease, hemorrhagic cystitis, cytomegalovirus and HHV-6 infection. Conclusion Common in allo-HSCT recipients, HHV-7 DNAemia is closely associated with conditioning with ATG and application of corticosteriod after allo-HSCT.

关 键 词：造血干细胞移植 疱疹病毒7型 人 移植物抗宿主病 巨细胞病毒感染 

分 类 号：R512.99[医药卫生—内科学]