异基因造血干细胞移植术后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：韩爱芝[1] 张婷[1] 王海进 夏瑞祥[1] 王海婧[1] 朱海波[1] 

机构地区：[1]安徽医科大学第一附属医院血液内科二病区,安徽合肥230022

出　　处：《中华医院感染学杂志》2014年第14期3471-3473,共3页Chinese Journal of Nosocomiology

基　　金：安徽省自然科学基金资助项目(1308085MH157)

摘　　要：目的分析实施异基因造血干细胞移植术患者的临床资料,探讨移植术后发生巨细胞病毒感染的危险因素,并提出防范移植术后发生巨细胞病毒感染的对策,以降低感染率。方法回顾性分析2006年12月-2013年10月82例实施异基因造血干细胞移植术患者的临床资料,调查异基因造血干细胞移植术后巨细胞病毒感染患者的临床资料,分析异基因移植术后发生巨细胞病毒感染的危险因素。结果异基因造血干细胞移植术后患者发生巨细胞感染的独立危险因素有年龄(OR=3.586)、受供者HLA相合性(OR=3.025);33例异基因造血干细胞移植术后感染巨细胞病毒患者经治疗后,25例获得痊愈出院,8例死亡,其中3例为继发间质性肺炎病死,3例继发细菌感染病死,1例为继发急性GVHD死亡,2例复发死亡,病死率为24.24%,1例疾病复发转院治疗。结论影响患者移植术后感染的因素主要为患者个体情况,术前及术后对患者进行全方位的身心护理,提高患者战胜疾病的意志,增强患者抵御疾病的主观能动性,以降低巨细胞病毒感染率,提高手术的成功率。OBJECTIVE To analyze the clinical data of the patients undergoing allogeneic hematopoietic stem cell transplantation,explore the risk factors for the postoperative cytomegalovirus infection,and propose the prevention countermeasures so as to reduce incidence of the infection.METHODS A total of 82patients who underwent the allogeneic hematopoietic stem cell transplantation from Dec 2006to Oct 2013were recruited in the study,then the clinical data of the subjects were retrospectively analyzed,the clinical data of the patients with postoperative cytomegalovirus infection were investigated,and the risk factors for the postoperative cytomegalovirus infection were analyzed.RESULTS The independent risk factors for the cytomegalovirus infection in the patients who underwent the allogeneic hematopoietic stem cell transplantation included the age（OR=3.586）and recipient and donor HLA consistency（OR=3.025）.After the treatment of the postoperative cytomegalovirus infection in the 33patients undergoing the allogeneic hematopoietic stem cell transplantation,25cases were cured and discharged,and 8cases died,among whom 3cases died from secondary bacterial infection,1case from secondary acute GVHD,2cases from recurrent disease,and the mortality rate was 24.24%;one case was transferred for treatment due to the recurrent disease.CONCLUSIONThe patient＇s individual situation is the leading influencing factor for the postoperative infection;it is an effective way to carry out the comprehensive mental and physical nursing,improve the patient＇will to overcome the disease,and intensify the patient＇s subjective initiative to prevent disease so as to reduce the incidence of cytomegalovirus infection and raise the success rate of surgery.

关 键 词：异基因造血干细胞移植术 巨细胞病毒 感染 危险因素 诊治 

分 类 号：R181.32[医药卫生—流行病学]