异基因造血干细胞移植后慢性肝脏移植物抗宿主病的相关危险因素分析及预后研究  

Related Risk Factor Analysis and Prognostic Study of Chronic Liver GVHD after Allogeneic HSCT

作　　者：李宣萱 翟岩[1] 范慧 LI Xuanxuan;ZHAI Yan;FAN Hui(Henan Cancer Hospital,Zhengzhou,450000)

机构地区：[1]河南省肿瘤医院,450000

出　　处：《实用癌症杂志》2022年第12期2054-2057,共4页The Practical Journal of Cancer

摘　　要：目的分析异基因造血干细胞移植(allo-HSCT)后慢性肝脏移植物抗宿主病的相关危险因素及预后。方法选取allo-HSCT后慢性肝脏移植物抗宿主病患者56例作为发生组,并以1∶1配比选取同期allo-HSCT后无慢性肝脏移植物抗宿主病患者56例作为未发生组。采用自制调查问卷收集两组性别、年龄、疾病状态、供体性别等信息,分析allo-HSCT后慢性肝脏移植物抗宿主病的相关危险因素及预后。结果患者年龄、人类白细胞抗原(HLA)配型是否相合、乙型肝炎表面抗原(HBsAg)表达、既往是否发生急性移植物抗宿主病(aGVHD)、移植前合并(心脏病、糖尿病)、是否加用抗胸腺细胞球蛋白(ATG)是影响allo-HSCT后慢性肝脏移植物抗宿主病的单因素(P<0.05);logistic回归分析显示,年龄>40岁、HBsAg表达阳性、既往发生aGVHD、移植前合并(心脏病、糖尿病)是allo-HSCT后慢性肝脏移植物抗宿主病的危险因素,HLA配型全相合、加用ATG是allo-HSCT后慢性肝脏移植物抗宿主病的保护因素(P<0.05)。发生组患者至随访完成,患者死亡15例,死亡率26.79%。结论allo-HSCT后慢性肝脏移植物抗宿主病影响因素较多,死亡率较高,临床应依据危险因素进行allo-HSCT后慢性肝脏移植物抗宿主病防治干预,以改善预后。Objective To analyze the relevant risk factors and prognostic studies of chronic liver GVHD after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods 56 patients with chronic liver GVHD after allo-HSCT were selected as occurrence groups,and 56 patients without chronic liver GVHD after allo-HSCT were selected with 1∶1 ratio.Gender,age,disease status and donor sex of the 2 groups were collected using our homemade questionnaire,analyzed the risk factors and prognostic of chronic liver GVHD after allo-HSCT.Results Age,human leukocyte antigen(HLA)matching,hepatitis B surface antigen expression(HBsAg),previous acute graft versus host disease(aGVHD),merger before transplantation(heart disease,diabetes),and added anti-thymocyte globulin(ATG)were single factors affecting chronic liver GVHD after allo-HSCT(P<0.05);The logistic regression analysis showed that,Age>40,positive expression of HBsAg,and previous pre-transplant aGVHD,(heart disease,diabetes)were risk factors for chronic liver GVHD after allo-HSCT,Complete compatibility of HLA mating,plus ATG are protective factors for chronic liver GVHD after allo-HSCT(P<0.05).In the occurrence group until the completion of follow-up,15 patients died,with a mortality rate of 26.79%.Conclusion There are many factors of chronic GVHD and high mortality after allo-HSCT,and chronic GVHD intervention should be conducted based on risk factors to improve prognosis.

关 键 词：慢性肝脏移植物抗宿主病 异基因 造血干细胞移植 人类白细胞抗原 抗胸腺 

分 类 号：R735.7[医药卫生—肿瘤]