异基因造血干细胞移植患者发生感染的相关因素  

Related Factors of Infection in Patients with Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：郭文静 GUO Wenjing(Department of Hematology,Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院血液科,河南郑州450000

出　　处：《河南医学研究》2023年第8期1400-1403,共4页Henan Medical Research

摘　　要：目的 对异基因造血干细胞移植患者发生感染的相关因素进行探讨。方法 采用回顾性研究,收集2019年1月至2022年10月于郑州大学附属肿瘤医院/河南省肿瘤医院行异基因造血干细胞移植的124例患者的临床资料,依据随访3个月期间是否发生感染将病历资料分为感染组(30例)与未感染组(94例)。由研究者设计一般资料调查表,收集患者一般资料及临床资料。对两组患者一般资料及临床资料进行分析,并采用多因素logistic回归分析异基因造血干细胞移植患者发生感染的相关因素。结果 两组患者性别、年龄、体重指数、住院时间、原发病类型、供者类型、干细胞来源、移植前白细胞计数、移植前中性粒细胞百分比对比,差异无统计学意义(P>0.05);感染组受供者人类白细胞抗原(HLA)相合率低于未感染组,发生急性移植物抗宿主反应(GVHD)、乙肝表面抗体(HBsAb)阳性的百分数大于未感染组;经多因素logistic回归分析显示,发生GVHD、HBsAb阳性为异基因造血干细胞移植患者发生感染的独立危险因素(OR=20.314、93.024,P<0.05),受供者HLA相合率高为阻碍异基因造血干细胞移植患者发生感染的保护因素(OR=0.878,P<0.05)。结论 受供者HLA相合率低、移植后发生GVHD及HBsAb阳性均会增加异基因造血干细胞移植患者的感染发生风险。Objective To explore the related factors of infection in patients with allogeneic hematopoietic stem cell transplantation.Methods A retrospective study was conducted to collect the clinical data of 124 patients who underwent allogeneic hematopoietic stem cell transplantation in Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital from January 2019 to October 2022.The medical records were divided into infection group(30 cases)and non-infection group(94 cases)according to whether infection occurred during the 3-month follow-up period.A general data questionnaire was designed to collect general and clinical data of patients by the investigator.The general and clinical data of the two groups were analyzed,and the related factors of infection in patients with allogeneic hematopoietic stem cell transplantation were analyzed by multivariate logistic regression.Results There were no statistical significant differences between the two groups in gender,age,body mass index,length of hospital stay,primary disease type,donor type,stem cell source,pre-transplant white blood cell count,and pre-transplant neutrophil percentage(P>0.05).The human leukocyte antigen(HLA)coincidence rate of the infection group was lower than that of the non-infection group,and the percentage of patients with acute graft versus host disease(GVHD)and positive hepatitis B surface antibody(HBsAb)were higher than that of the non-infection group(P<0.05).Multivariate logistic regression analysis showed that GVHD and HBsAb positive were independent risk factors for infection in patients with allogeneic hematopoietic stem cell transplantation(OR=0.314,93.024,P<0.05),and the high HLA coincidence rate of recipients was the protective factor preventing infection in patients with allogeneic hematopoietic stem cell transplantation(OR=0.878,P<0.05).Conclusion The low HLA coincidence rate of recipients,GVHD and HBsAb positive after transplantation will increase the risk of infection in patients with allogeneic hematopoietic stem cell transplantat

关 键 词：异基因造血干细胞移植 感染 移植物抗宿主反应 

分 类 号：R733[医药卫生—肿瘤]