儿童造血干细胞移植患者人巨细胞病毒与疱疹病毒6型感染及相互关系  

Incidence and relationship of human cytomegalovirus infection and human herpesvirus 6 infection in pediatric patients after hemopoietic stem cell transplantation

作　　者：吕典一[1] 秦茂权[1] 王燕[1] 高立伟[1] 谢正德[1] 

机构地区：[1]首都医科大学附属北京儿童医院,100045

出　　处：《中华实验和临床病毒学杂志》2010年第6期455-457,共3页Chinese Journal of Experimental and Clinical Virology

基　　金：首都医科大学基础一临床科研合作基金项目（09JL52）;北京市卫生系统高层次卫生技术人才专项经费（2009-3-42）

摘　　要：目的 了解儿童造血干细胞移植患者术后人巨细胞病毒与疱疹病毒6型的感染情况以及相互关系.方法 患者为2007年6月至2009年10月间北京儿童医院血液病中心的造血干细胞移植的患儿,患儿术后每周采集外周静脉血,分别应用荧光定量PCR和常规PCR检测患者血清中CMV DNA载量及外周全血中HHV-6,并对HHV-6进行分型.结果 共52例造血干细胞移植患者,636份标本.20例造血干细胞移植患者共52份标本CMV-DNA检测阳性,中位检出时间为术后56d.CMV感染的总发生率为38.5%（20/52）.其中异基因造血干细胞移植CMV感染的发病率为47.6%（20/42）,晚发性CMV感染的发生率为22.2%（6/27）.3例CMV感染患者死亡,其中2例诊断CMV间质性肺炎.14例患者共33份血标本HHV-6 PCR阳性,中位检出时间为术后23d,HHV6感染的总发生率为26.9%（14/52）,其中异基因HSCT患者HHV6感染的发生率为31%（13/42）,且均为B型.20例CMV阳性的造血干细胞移植患者中,有6例发生CMV感染,HHV-6与CMV共感染率为30%（6/20）.结论 儿童造血干细胞移植患者术后CMV感染率和HHV-6感染率均较高,造血干细胞移植术后发生较早的HHV-6感染和发生较晚的CMV感染之间的关系有待进一步研究.Objective To study the incidence of human cytomegalovirus （CMV） and human herpesvirus 6（HHV-6） infection in pediatric patients with hemopoietic stem cell transplantation （HSCT）,and to explore the relationship between CMV and HHV-6 infection in pediatric patients with HSCT.Methods Pediatric patients with HSCT in hemotology center of Beijing Children＇s Hospital were enrolled into this study from June 2007 to October 2009. Peripheral blood were collected every week after HSCT, and Fluorescent quantitation PCR and conventional PCR were used to detect CMV DNA load in serum and HHV-6 DNA in peripheral blood respectively. Genetic typing was conducted on HHV-6. Results Fifty two pediatric patients with HSCT were enrolled into this study, and six hundreds and thirty six specimens were collected totally. CMV DNA was detected in fifty two specimens from twenty cases. The median time was 56days after HSCT. The incidence of CMV infection was 38.5% （20/52）in all HSCT patients and 47. 6% （20/42） in allogene HSCT patients. The incidence of late CMV infection was 22.2% （6/27）in allogene HSCT.Three patients died of C MV infection,and two died of CMV interstitial pneumonia. HHV-6 DNA was detected in thirty three specimens from fourteen cases. The median time was 23 days after HSCT. The incidence of HHV-6 infection was 26.9% （ 14/52 ） in all HSCT patients and 31% （ 13/42 ） in allogene HSCT patients. The genotype of HHV6 was all type B. HHV-6 DNA was positive in six of twenty cases with CMV infection. The

关 键 词：造血干细胞移植 巨细胞病毒 疱疹病毒6型 人 

分 类 号：R7[医药卫生—临床医学] R4