CMV和EBV共感染可影响造血干细胞移植患者预后  

CMV and EBV co-infection affecting patient prognosis after hematopoietic stem cell transplantation

作　　者：张娜[1] 牛伟华 孙媛媛[1] 贾玫[1] ZHANG Na;NIU Weihua;SUN Yuanyuan;JIA Mei(Department of Clinical Laboratory,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院检验科,北京100044

出　　处：《检验医学》2023年第8期760-765,共6页Laboratory Medicine

基　　金：首都临床特色应用研究资助项目(Z181100001718156)。

摘　　要：目的探讨巨细胞病毒(CMV)和EB病毒(EBV)共感染与造血干细胞移植(HSCT)患者预后的相关性。方法选取2018年1月—2019年1月北京大学人民医院血液科327例接受HSCT的患者,其中CMV和EBV共感染75例(共感染组),CMV或EBV感染165例(单一感染组),CMV和EBV均未感染87例(无感染组)。收集HSCT患者的临床基本资料和移植后CMV、EBV感染情况。采用Kaplan-Meier生存曲线和Cox比例回归分析CMV和EBV共感染是否是HSCT患者预后的危险因素。结果327例患者中,有226例(69.1%)年龄≤40岁。共感染组≤40岁患者所占比例高于>40岁患者(P<0.05)。人白细胞抗原(HLA)匹配方面,共同感染组半相合所占比例高于单一感染组和无感染组(P<0.05)。共感染组、单一感染组、无感染组患者1年总体生存率(OS)分别为86.7%、85.4%、95.4%,差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析结果示,CMV和EBV共感染是HSCT术后患者1年OS的危险因素(P<0.05)。Cox比例回归分析结果显示,CMV和EBV共感染、单一感染均是HSCT术后患者1年OS的危险因素[风险比(HR)值分别为12.553、13.108,95%可信区间(CI)分别为1.456~108.230、1.683~102.062,P值分别为0.021、0.014]。结论CMV感染(无论是否伴有EBV感染)可降低HSCT患者术后1年OS。Objective To investigate the correlation between cytomegalovirus(CMV)and Epstein-Barr virus(EBV)co-infection and the prognosis of patients after hematopoietic stem cell transplantation(HSCT).Methods Totally,327 patients with CMV and EBV co-infection(75 cases),CMV or EBV infection group(165 cases)and no infection group(87 cases)were enrolled in the Hematology Department of Peking University People's Hospital.The clinical data and CMV and EBV infection status were collected.Kaplan-Meier survival curve and Cox proportional regression analysis were used to analyze whether CMV and EBV co-infection was a risk factor for the prognosis of patients after HSCT.Results The patients was mainly≤40 years old(226 cases,69.1%),and the proportion of patients≤40 years old in CMV and EBV co-infection group was higher than that in patients>40 years old(P<0.05).In terms of human leukocyte antigen(HLA)matching,the proportion of haploidentical in CMV and EBV co-infection group was higher than that in CMV or EBV infection group and no infection group(P<0.05).The one-year overall survival(OS)rates of CMV and EBV co-infection group,CMV or EBV infection group and no infection group were 86.7%,85.4%and 95.4%(P<0.05).Kaplan-Meier survival curve results showed that CMV and EBV co-infection was a risk factor for one-year OS after HSCT(P<0.05).Cox proportional regression analysis showed that CMV and EBV co-infection and CMV or EBV infection were risk factors for one-year OS after HSCT[hazard ratios(HR)were 12.553 and 13.108,95%confidence interval(CI)1.456-108.230 and 1.683-102.062,P=0.021 and 0.014,respectively].Conclusions CMV infection(with or without EBV infection)may reduce one-year OS after HSCT.

关 键 词：巨细胞病毒 EB病毒 共感染 造血干细胞移植 预后 

分 类 号：R446.1[医药卫生—诊断学]