118例造血干细胞移植患者中枢神经系统并发症的临床研究  

Clinical study of central nervous system complication after hematopoietic stem blood transplantation

作　　者：杨益莲 丁家华[1] 

机构地区：[1]东南大学附属中大医院血液科,江苏南京210009

出　　处：《现代医学》2016年第5期716-720,共5页Modern Medical Journal

摘　　要：目的：探究造血干细胞移植（HSCT）后中枢神经系统（CNS）并发症的发生及影响因素。方法：回顾性分析单中心HSCT患者118例的临床资料,其中亲缘间干细胞移植47例,无关供者干细胞移植40例,自体干细胞移植9例,脐带血干细胞移植22例。结果：118例移植患者中发生CNS并发症21例,其中癫痫15例（并发颅内出血3例,并发颅内感染2例,并发CNS白血病1例）,颅内感染4例,颅内出血5例,CNS白血病3例。随访10～92个月,21例发生CNS并发症的患者死亡13例,占61.9%。结论：HSCT后CNS并发症的病死率较高,癫痫是最常见的CNS并发症,年龄≤14岁、发生Ⅱ度以上移植物抗宿主病（GVHD）、免疫抑制剂（CNI）血药浓度过高及选择脐带血是发生CNS并发症的高危因素。Objective： To analyze the clinic characteristics and risk factors of central nervous system（ CNS）complication after hematopoietic stem blood transplantation（ HSCT）. Methods： A retrospective study was conducted to analyze the 118 patients which included 47 cases from relative donor,71 cases from non relative donor. Autologous stem cell graft was used for 9 patients,while 22 patients were treated with cord blood stem cell transplantation. Results： CNS complications occurred in 21 out of 118 patients after HSCT,which epilepsy was occurred in 15 cases（ 3 cases of epilepsy caused by intracranial hemorrhage,2 cases by intracranial infection,1cases by central nervous system leukemia）,4 cases underwent intracranial infection,5 case were diagnosed intracranial hemorrhage and central nervous system leukemia in 3 cases. Follow up for 10 ～ 92 months,13 patients（ 61. 9%） died of CNS complications. Conclusion： The rate of mortality of CNS complication is higher after HSCT,epilepsy is the most frequent complication of CNS. Aged less than 14 years,more than Ⅱdegree GVHD,high CNI concentration and cord blood are risk factors of CNS complications in HSCT.

关 键 词：造血干细胞移植 中枢神经系统 并发症 

分 类 号：R457.7[医药卫生—治疗学]