异基因造血干细胞移植并发致死性间质性肺炎  

Fatal interstitial pneumonitis after allogeneic hematopoietic stem cell transplantation in children

作　　者：钱新华[1] 朱为国[1] 赵彤[1] 邢献志[1] 李夏新[1] 程少杰[1] 

机构地区：[1]第一军医大学附属南方医院,广州510515

出　　处：《实用儿科临床杂志》1997年第3期145-147,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨小儿异基因造血于细胞移植并发间质性肺炎（IP）的发病病因、临床特点、危险因素及防治措施。方法根据尸解病理检查及聚合酶键反应技术对病毒病原学检测结果，结合临床移植资料综合分析。结果14例移植患儿中并发IP3例（3／14），分别死于十19天、＋76天、＋150天;3例IP中2例移植前后外周血及尸解肺组织直到CMV包涵体;4例3～4应急性GVHD患儿中3例并发IP，10例0～2度急性GVHD无1例并发IP。结论IP是移植早期死亡的重要原因之一，巨细胞病毒感染是IP的主要病原，GVHD严重程度与移植后并发IP密切相关.Objectives: To investigate the incidence. iteology,risk factors,and methods of prophylaxis and treatment of fatal interstitial pneumonitis after allogeneic hematopoietic .tem cell transpisntation in children.Methods: The general analyais was done according to the results of autopsy,examination of pathology and iteology as well as the clinical materials of transplantation in 14 Patients.Results: 1. There were 3 patients complicated with interstitial pneumonitis in 14 children treated with allogeneic hematopoietic stem cell transplantation (3/14). They died at + 19, + 79, + 150 day respective1y. 2. The cytomegalovirus DNA was demonstrated in 2 patients'blood before and after allogeneic hematopoietic stem cell transpisntation and the lung tissue in autopsy. 3. The interstitial pneumonitis occured in 3 cases of 4 children with 3～4 degree graft versus host disease (GVHD). However no interstitial pneumonitis occured in 10 children with 0～2 degree GVHD.Concluslons: Interstitial pneumonitis was one of the death causes at an early stage after transplantation. Cytomegalovirus infection was a major cause of interstitial pneumonitis. ffevere GVHD was an important risk factor in ducing interstitial pneumonitis.

关 键 词：异基因 造血干细胞移植 间质性肺炎 并发症 儿童 

分 类 号：R457.9[医药卫生—治疗学] R725.631.3[医药卫生—临床医学]