异基因造血干细胞移植手术后并发巨细胞病毒视网膜炎的全身危险因素及流行病学研究现状与进展  

Systemic risk factors and epidemiology of cytomegalovirus retinitis status-post allogeneic bone marrow hematopoietic stem cell transplantation

作　　者：张川 黎晓新[1] 苗恒[1] 侯婧[1] Zhang Chuan;Li Xiaoxin;Miao Heng;Hou Jing(Department of Ophthalmology,People’s Hospital of Peking University,Beijing 100133,China)

机构地区：[1]北京大学人民医院眼科,100044

出　　处：《中华眼底病杂志》2021年第5期404-408,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：国家自然科学基金青年基金(81800847);北大医学青年科技创新发展平台青年培育基金(BMU2020PYB014);北京大学人民医院第10届"学术新星"基金(RS2018-05)。

摘　　要：巨细胞病毒(CMV)性视网膜炎(CMVR)是血液病患者异基因造血干细胞移植手术后常见的眼部机会性感染,常发生于手术后3个月内发生CMV激活、血液CMV峰值较高、CMV病毒血症时间较长、人类白细胞抗原不相合移植、非亲缘供体移植、单倍体移植、儿童造血干细胞移植、淋巴细胞植活延迟、手术后发生急慢性移植物抗宿主病患者。患者视力预后与CMVR在视网膜上病变的面积、累及象限的个数及是否累及黄斑、玻璃体CMV载量有关,与是否合并血液及玻璃体液的Epstein-Barr病毒感染无关。CMVR的发病率逐年升高,关注全身危险因素及流行病学可以帮助眼科医生在诊疗时提供更有效的指导意见,帮助患者改善视力预后,减少甚至避免CMVR致盲的发生。Cytomegalovirus(CMV)retinitis(CMVR)is a common opportunistic infection of the eye after allogeneic hematopoietic stem cell transplantation in patients with hematological diseases.It often occurs within 3 months after the operation,with CMV activation and high blood CMV peaks.It often occurs on patients with long-term CMV viremia,human leukocyte antigen incompatible transplantation,unrelated donor transplantation,haploid transplantation,childhood hematopoietic stem cell transplantation,delayed lymphocyte engraftment,acute and chronic graft-versus-host disease after surgery.The visual prognosis of patients is related to the area of CMVR lesions on the retina,the number of quadrants involved,whether the macula is involved,and the CMV load of the vitreous body is involved,and it is not related to whether the Epstein-Barr virus infection is combined with blood and vitreous humor.The incidence of CMVR is increasing year by year.It is helpful that paying attention to systemic risk factors and epidemiology can provide more effective guidance for ophthalmologists during diagnosis and treatment,help patients improve the prognosis of vision,and reduce or even avoid the occurrence of blindness caused by CMVR.

关 键 词：巨细胞病毒视网膜炎 造血干细胞移植 危险因素 流行病学 综述 

分 类 号：R774.11[医药卫生—眼科]