移植物抗宿主病的临床分析  

A Clinical Analysis of Graft-Versus-Host Disease

作　　者：伏瑞祥[1] 孙爱宁[1] 仇惠英[1] 唐晓文[1] 傅铮铮[1] 苗喵[1] 马骁[1] 刘跃均[1] 吴德沛[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液研究所,苏州215006

出　　处：《苏州大学学报（医学版）》2003年第3期327-329,343,共4页Suzhou University Journal of Medical Science

摘　　要：目的　分析异基因干细胞移植后移植物抗宿主病 (GVHD)与预处理方式、干细胞来源和GVHD预防的关系及其对预后的影响。方法　对 5 6例异基因造血干细胞移植患者进行 2～ 2 5个月的临床随访。结果　 (1)Ⅱ°～Ⅳ°急性GVHD的激素疗效明显不如Ⅰ°急性GVHD ,激素耐药的急性GVHD患者预后较差 (P <0 .0 5 ) ;(2 )非亲缘性骨髓移植患者的急、慢性GVHD发病率高于亲缘性骨髓移植 (R -BMT)患者 ,但均无显著差异 (P >0 .0 5 ) ;(3)非清髓性外周血干细胞移植 (NST)患者的急、慢性GVHD发病率与R -BMT患者相比无显著差异 (P >0 .0 5 ) ,但激素耐药的急性GVHD比例明显高于R -BMT患者 (P <0 .0 5 )。结论　GVHD是影响NST患者预后的主要因素 ,该类患者GVHD的预防和激素耐药的急性GVHD的治疗有待研究。Objective To analysize the difference of graft-versus-host disease(GVHD) follo- wing allogeneic stem cell transplantation between different condition regimens,stem sourses,prophylaxis of GVHD and the effect to prognosis. Methods Fifty six patients received clinic follow-up two to twenty five months following allogeneic stem cell transplantation. Results (1)The effect of steroids was more poor in patients of Ⅱ°～Ⅳ°acute GVHD( P <0.05), and the prognosis of those patients who was refractory to steroids was more poor( P <0.05);(2)There was no significant difference in the rate of acute and chronic GVHD between related and unrelated bone marrow transplantation( P >0.05);(3)There was no significant difference in the rate of acute and chronic GVHD between related bone marrow transplantation and nonmyeloablative peripheral blood stem cell transplantation(NST),but the ratio of steroids-resistent acute GVHD was significantly higher in patients of NST( P < 0.05 ). Conclusion GVHD is the major factor that affects the prognosis of NST,and the prophylaxis of GVHD in these patients and the trentment of sterotds-resistent acute GRHD need more attention.

关 键 词：移植物抗宿主病 预处理方式 干细胞来源 预防 临床分析 非亲缘性骨髓移植 激素治疗 

分 类 号：R457.7[医药卫生—治疗学]