造血干细胞移植术后患者巨细胞病毒感染发生率及临床转归  

INCIDENCE OF CYTOMEGALOVIRUS PP65 ANTIGENEMIA AND ITS CLINICAL OUTCOME IN PATIENTS FOLLOWING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION

作　　者：董陆佳[1] 李欲航[1] 秦茂权[1] 余志勇[1] 胡亮钉[1] 徐晨[1] 宁红梅[1] 贾蜀琼[1] 卢淑鹃[1] 

机构地区：[1]解放军第307医院

出　　处：《解放军医学杂志》2002年第7期601-603,共3页Medical Journal of Chinese People's Liberation Army

基　　金：全军医学科研"九五"计划面上项目基金资助课题 (编号 98M1 30 )

摘　　要：采用免疫组化法对 10 0例异体造血干细胞移植 (Allo HSCT)和 14例自体造血干细胞移植 (Auto HSCT)术后患者、17例非移植患者以及 2 7例正常供者CMVpp6 5抗原血症检出率进行分析。 10 0例Allo HSCT术后患者随访观察 18(4～36 )个月。结果 :Allo HSCT者 91%在不同病期出现CMVpp6 5阳性 (CMV I) ,其中 5 6 %出现CMV疾病 ;急性移植物抗宿主病 (GVHD)发生率为 5 4 % ,时间为 2 5 (11～72 )天 ;慢性GVHD 5 2 9% ;CMV相关性死亡率为 2 1% ,在各种死因中占主要地位。CMV I在异体移植后好发 ,而在Auto HSCT术后患者、非移植患者以及正常人群极为少见。提示 ,CMV感染与急慢性GVHD呈显著相关性 ,是影响预后的主要因素。CMV related matrix protein pp65 antigenemia was screened in 100 Allo HSCT patients after transplantation. As control groups, samples from fourteen autologous HSCT patients, seventeen patients with various hematological malignant disorders, as well as twenty seven normal donors also were detected. CMV antigenemia was found in 91/100 Allo HSCT patients (91%) after transplantation. 56 % patients with antigenemia developed CMV disease. 54% patients developed acute GVHD. In 87 patients survived more than three months, 52 9% patients developed chronic GVHD. After follow up 18(4～36) months post transplantation, 21 patients died of CMV related diseases. Compared with autologous and non transplantation patients, CMV antigenemia and CMV diseases were particularly associated with Allo HSCT patients. It was obviously correlated with acute and chronic GVHD. CMV infection is a major factor affecting the clinical outcome of Allo HSCT patients.

关 键 词：发生率 转归 造血干细胞移植 巨细胞病毒感染 移植物抗宿主病 术后感染 

分 类 号：R457.7[医药卫生—治疗学] R63[医药卫生—临床医学]