异基因造血干细胞移植后纯红细胞再生障碍性贫血发生的影响因素分析  

Analysis of influencing factors on occurrence of posttransplant pure red cell aplastic anemia following allogeneic hematopoietic stem cell transplantation

作　　者：马威[1] 张定宇[2] 尹建平[2] 张义成[3] 江梦天[2] 肖毅[3] 余谨[2] 姚立[2] 

机构地区：[1]武汉市第一医院中心实验室,湖北武汉430022 [2]武汉血液中心 [3]华中科技大学同济医学院附属同济医院血液病科

出　　处：《中国输血杂志》2013年第7期603-606,共4页Chinese Journal of Blood Transfusion

基　　金：武汉市临床科研基金重点项目(武卫[2007]043)

摘　　要：目的分析异基因造血干细胞移植后纯红细胞再生障碍性贫血(PRCA)发生的危险因素。方法收集完成全部观察的225名与供者HLA匹配的异基因造血干细胞移植患者,其中21例(9.33%)发生移植后PRCA。用SPSS统计分析软件对移植红细胞生长延缓期时间(d)、免疫溶血病发生、ABO血型相容性、aGVHD分级、原发病、血浆sHLA-G1和G5含量以及年龄、性别等作单因素Logistic回归分析,然后对有明显差异的观察指标作多因素Logistic回归分析。结果单因素Logistic回归分析显示:ABO血型相容性、aGVHD分级、原发病、sHLA-G5含量、患者年龄及性别等因素OR值分别为0.596、0.553、1.079、1.007、1.023和2.961(P值分别为0.129、0.720、0.173、0.227、0.334和0.110),移植后红细胞生长延缓期时间、sHLA-G1含量以及溶血病发生对累积Logistic模型的OR值分别0.983、0.033、12.799(P值分别为0.001、0.033、0.003),多因素Logistic回归分析结果显示移植后红细胞生长延缓期时间、sHLA-G1含量以及溶血病发生对Logistic模型有统计学意义(OR值为1.017、0.964、0.110,P值分别为0.001、0.045、0.006)。结论移植红细胞生长延缓期时间、血浆sHLA-G1含量以及溶血病发生是移植后PRCA发生的主要影响因素。Objective To analysis the influencing factors on occurrence of posttransplant pure red cell aplasia （PRCA） following allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods HLA-matched with donors,225 patients after allogeneic hematopoietic stem cell transplantation were investigated,21 patients （9. 33% ） developed pure red cell aplasia among them. On occurrence of posttransplant PRCA ,the multiple influencing factors were analysed in the logistic model regression,consisting of the lag phase time （days） on engrafted red cell growth, occurrence of immunohemolytic disease,compatibility of ABO blood type, classification of aGVHD, primary diseases, sHLA-G1 and G5 contents in blood plasma, age an.d sex , etc. Results In logistic model among multiple factors,the significantly different were the lag phase time on engrafted red cell growth ,occurrence of immunohemolytic disease and sHLA-G1 contents in blood plasma （P 〈0. 05） ,and the not significant were compatibility of ABO blood type, classification of aGVHD, primary diseases, sHLA-G5 contents in blood plasma, age, sex, and etc（P 〉 0. 05）. Conclusion On occurrence of posttransplant PRCA after allo-HSCT,the main impacting factors were the lag phase time on grafted red cell growth,occurrence of immunohemolytic disease and sHLA-G1 contents in blood plasma.

关 键 词：造血干细胞移植 异基因 再生障碍性贫血 纯红细胞 LOGISTIC模型 回归分析 

分 类 号：R457.7[医药卫生—治疗学] R556.5[医药卫生—临床医学]