异基因造血干细胞移植后发生巨细胞病毒感染的临床分析  

Clinical Analysis of Cytomegalovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：郭智[1] 陈惠仁[1] 刘晓东[1] 边佳明[2] 何学鹏[3] 楼金星[1] 陈鹏[1] 杨凯[1] 刘丹[1] 张媛[1] 

机构地区：[1]北京军区总医院血液科,北京100700 [2]北京军区总医院药理科,北京100700 [3]北京军区总医院血液科科,北京100700

出　　处：《中国实验血液学杂志》2012年第4期971-974,共4页Journal of Experimental Hematology

摘　　要：本研究总结巨细胞病毒(CMV)感染的发生及治疗。对北京军区总医院血液科2010年1月至2012年1月140例异基因造血干细胞移植(allo-HSCT)患者的临床资料进行了回顾性分析。结果表明,140例allo-HSCT中48例患者发生移植后CMV感染,发生率为34.3%,首次检出CMV-DNA阳性中位时间为移植后45(33-68)d,CMV定量范围为1.25×103-5.5×106,其中2例为CMV相关性间质性肺炎,5例为CMV相关性出血性膀胱炎。发生移植物抗宿主病(GVHD)患者共65例,其中合并CMV感染32例,占49.2%。应用更昔洛韦、膦甲酸钠抗CMV治疗45(33-68)d后CMV-DNA转阴,有效率为100%。共有12例患者治疗过程中出现一过性的白细胞和血小板减少。结论:allo-HSCT后较易发生CMV感染,发生GVHD的患者CMV感染发生率也较高,更昔洛韦、膦甲酸钠对allo-HSCT后CMV感染的治疗效果可靠,且不良反应少。The objective of this study was to explore the incidence and therapeutrc efficacy of cytomegalovirus （CMV） infection after allogeneic hematopoietic stem cell transplantation（ allo-HSCT）. The clinical data of 140 patients undergoing allo-HSCT in our department of hematology from 2010-01 to 2012-01 were retrospectively analyzed. The results showed that the incidence of CMV infection was 4.3% （48/140）, the time for the first detection of positive CMV-DNA was at day 45 （33 to 68） after allo-HSCT, and the CMV quantitative range was 1.25×10^3 -5.5×10^6. There were 2 cases of CMV-related interstitial pneumonia and 5 cases of hemorrhagic bladder inflammation. A total of 65 patients suffered from graft versus host disease （GVHD）, in which 32 cases （49.2%） were accompanied with CMV infection, CMV-DNA negative in patients treated with ganciclovir, foscarnet sodium anti-CMV was at day 45 （ 33 to 68 ） with the effective rate of 100%. 12 patients with CMV infection were accompanid with transient neutropenia and thrombocytopenia. It is concluded that after allo-HSCT the CMV infection occurres frequently. The patients with GVHD have a higher incidence of CMV infection. Ganciclovir and foscarnet sodium are reliable to be used for treatment of CMV infection with fewer adverse reactions.

关 键 词：异基因造血干细胞移植 巨细胞病毒感染 移植物抗宿主病 

分 类 号：R457.7[医药卫生—治疗学]