异基因造血干细胞移植术后病毒感染与环孢素血药浓度的相关性研究  

Correlation between viral infection and cyclosporine concentration after allogeneic hematopoietic stem cell transplantation

作　　者：龚珠 金米聪[2] GONG Zhu;JIN Micong(Department of Clinical Laboratory,People's Hospital Affiliated to Ningbo University,Ningbo,Zhejiang,315100,China;Key Laboratory of Health Risk Appraisal for Trace Toxic Chemicals of Zhejiang Province,Ningbo Municipal Center for Disease Control and Prevention)

机构地区：[1]宁波大学附属人民医院临床检验中心,浙江宁波315100 [2]宁波市疾病预防控制中心浙江省微量有毒化学物健康风险评估技术研究重点实验室

出　　处：《临床血液学杂志》2025年第2期101-104,共4页Journal of Clinical Hematology

摘　　要：目的:探讨异基因造血干细胞移植(allo-HSCT)患者在接受免疫抑制剂环孢素A(CsA)治疗后病毒感染与血药浓度的相关性,为临床合理用药提供依据。方法:采用实时定量PCR法(RT-PCR)定期监测医院行allo-HSCT的120例患者巨细胞病毒(CMV)和EB病毒(EBV),化学发光微粒子法(CMIA)定期监测CsA血药浓度,然后分析病毒感染率与血药浓度的关系。结果:120例allo-HSCT患者移植后CMV感染阳性率为61.7%(74/120),EBV感染阳性率为24.2%(29/120),CMV和EBV双重感染阳性率为19.2%(23/120),移植后患者发生CMV感染率较高。单病毒感染组和双重病毒感染组的CsA血药浓度差异无统计学意义(P>0.05)。病毒感染阳性组的CsA血药浓度明显高于阴性组(P<0.05)。CsA血药浓度与CMV、EBV感染阳性率及拷贝数等级间呈正相关。结论:免疫抑制剂CsA血药浓度偏高可能增加allo-HSCT后CMV和EBV感染的风险,且感染程度与CsA血药浓度相关。Objective:To investigate the correlation between viral infection and blood drug concentration in allogeneic hematopoietic stem cell transplantation(allo-HSCT)patients after receiving immunosuppressant cyclosporine A(CsA),so as to provide a basis for clinical rational drug use.Methods:Cytomegalovirus(CMV)and Epstein-Barr virus(EBV)were regularly monitored by real-time quantitative PCR(RT-PCR),and CsA plasma concentration was regularly monitored by chemiluminescence microparticle method(CMIA),and the relationship between viral infection rate and blood concentration was analyzed.Results:The positive rate of CMV infection in 120 patients with allo-HSCT was 61.7%(74/120),the positive rate of EBV infection was 24.2%(29/120),the positive rate of CMV and EBV coinfection was 19.2%(23/120),and the incidence of CMV infection was high in patients after transplantation.There was no diference in the plasma concentration of CsA between the single-virus infection group and the dual-virus infection group.The blood concentration of CsA in the positive group was significantly higher than that in the negative group(P<o.05).There was a positive correlation between the plasma concentration of CsA and the positive rate of CMV and EBV infection and copy number grade.Conclusion:High plasma concentrations of immunosuppressant CsA may increase the risk of CMV and EBV infection after allo HSCT,and the degree of infection may be related to CsA plasma concentration.

关 键 词：异基因造血干细胞移植 病毒感染 血药浓度 

分 类 号：R457.7[医药卫生—治疗学]