重组人粒细胞集落刺激因子致健康供者急性肺损伤  

Acute lung injury due to recombinant human granulocyte colony-stimulating factor in a healthy donor

作　　者：庞宇慧[1] 张少飞 王荣孝[1] 曹建柱 刘金霞 张耀臣 Pang Yuhui;Zhang Shaofei;Wang Rongxiao;Cao Jianzhu;Liu Jinxia;Zhang Yaochen(Department of Hematology,Shijiazhuang Ping'an Hospital,Shijiazhuang 050021,China;Department of Cardiology,Shijiazhuang Ping'an Hospital,Shijiazhuang 050021,China)

机构地区：[1]石家庄平安医院血液科,石家庄050021 [2]石家庄平安医院心内科,石家庄050021

出　　处：《药物不良反应杂志》2024年第9期568-570,共3页Adverse Drug Reactions Journal

基　　金：中华中医药学会血液系统疾病课题(202169-004)。

摘　　要：1名36岁健康男性作为异体干细胞移植供者,为动员外周血造血干细胞给予重组人粒细胞集落刺激因子(rhG-CSF)注射液300μg皮下注射、1次/d(连续使用5 d)。供者在rhG-CSF动员的第4天行外周血干细胞采集术后加用rhG-CSF 250μg。次日出现干咳、胸闷气短、呼吸困难,胸部CT检查示双肺弥漫性斑片状和结节状阴影,相关检查除外肺部细菌/病毒感染和心功能衰竭,考虑为rhG-CSF所致的药物性急性肺损伤。给予糖皮质激素和对症处理后,症状逐渐减轻,外周血干细胞采集术顺利。继续应用糖皮质激素,供者症状进一步好转;复查胸部CT,较前明显好转。后期随访3年,供者工作、生活正常,未再出现肺部不适。A 36-year-old healthy male served as an allogeneic hematopoietic stem cell donor was given recombinant human granulocyte colony-stimulating factor injection(rhG-CSF)300μg by subcutaneous injection once daily for 5 consecutive days.On day 4 of stem cell mobilization,peripheral stem cell collec-tion was performed and rhG-CSF 250μg was given in addition.The donor experienced dry cough,dyspnea,and difficulty breathing on the next day.Chest CT scan showed diffuse patchy and nodular shadows in both lungs,and relevant tests excluded bacterial/viral infection of the lungs and heart failure.It was considered to be acute lung injury caused by rhG-CSF.After giving glucocorticoids and symptomatic treatments,the symp-toms gradually subsided,and the peripheral blood stem cell collection was successful.In the continuing treatment of glucocorticoids,the symptoms of the donor were further improved,and chest CT scan showed marked improvement.At a 3 years of follow-up,the donor'work and life were normal,and no lung discomfort symptoms recurred.

关 键 词：造血干细胞移植 急性肺损伤 重组人粒细胞集落刺激因子 健康供者 

分 类 号：R457.7[医药卫生—治疗学] R563[医药卫生—临床医学]