单倍型相合骨髓移植后带状疱疹并发症的临床观察  

Study of herpes zoster in seventeen patients after HLA-haploidentical bone marrow transplantation

作　　者：薛梅[1] 朱玲[1] 刘静[1] 阎洪敏[1] 丁利[1] 段连宁[1] 王恒湘[1] 

机构地区：[1]空军总医院血液科,北京100036

出　　处：《临床血液学杂志》2008年第3期237-239,共3页Journal of Clinical Hematology

摘　　要：目的:观察单倍型相合骨髓移植后带状疱疹发病情况、诊治及预后。方法:对单倍型相合骨髓移植后带状疱疹的发生时间、临床表现、治疗及预后进行总结分析。结果:可评估的120例接受单倍型相合骨髓移植患者中有17例并发带状疱疹,发病率14.1%,其中14例发生在移植后6个月内。10例发生过急性移植物抗宿主病(aGVHD),临床主要表现为区域性皮肤疱疹。15例接受阿昔洛韦静脉滴注治疗,2例阿昔洛韦片口服治疗。平均治疗时间为18.5d,全部治愈。5例出现严重疱疹后神经痛,需强效止痛,无泛发性疱疹及内脏受累病例,无疱疹相关死亡。结论:带状疱疹是单倍型相合骨髓移植后常见的病毒感染性疾病,主要发生在骨髓移植术后6个月内免疫功能低下阶段,阿昔洛韦治疗有较好疗效,预后良好。Objective：To analyze the incidence, characteristics, treatment and outcome of herpes zoster in patients after HLA-Haploidentical bone marrow transplantation（BMT）. Method：A retrospective study was conducted on patients complicated with herpes zoster after HLA-Haploidentical BMT from May 1999 to May 2006, with emphasis on clinical date. treatment, follow-up results. Result： Herpes zoster occurred in seventeen （14. 1 %） of the total evaluated 120 patiens who were trasplated. Fourteen of these 17 patients （82 %） had herpes zoster within 6 mothes following HLA- Haploidentical BMT. Most had the presence of acute GVHD . It can be diagnosed by symptom and physical examination. The characteristic vesicular skin lesions occurred in a dermatomal distribution in all cases. No patients had visceral dissemination or died of herpes zoster although five patients developed severe postherpetic neuralgia. Only one developed herpes zoster diseases during the period of acyclovir（ACV） prophyloxis. All cases were treated with ACV for 18.5 days averagely. Of them 15 cases by intravenously and the other 2 ca- ses was by oral. All were cured. Conclusion： Herpes zoster was a common virus disease in patients whose immune function was very lower after HLA-Haploidentical BMT. Most of the 17 cases were found during 6 monthes. The acyclovir was effective for the treatment of herpes zoster. All the patients have a good prognosis.

关 键 词：移植 带状疱疹 单倍型相合 

分 类 号：R617[医药卫生—外科学]