中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2012年
3期
179-183
,共5页
陈瑶%黄晓军%王峰蓉%闫晨华%王昱%张圆圆%韩伟%陈欢%刘代红%刘开彦%许兰平
陳瑤%黃曉軍%王峰蓉%閆晨華%王昱%張圓圓%韓偉%陳歡%劉代紅%劉開彥%許蘭平
진요%황효군%왕봉용%염신화%왕욱%장원원%한위%진환%류대홍%류개언%허란평
发热%感染%外周血干细胞输注
髮熱%感染%外週血榦細胞輸註
발열%감염%외주혈간세포수주
Fever%Infection%Peripheral blood stem cell transfusion
目的 探讨接受异基因外周血干细胞输注后24h内患者新出现发热的发生率和病因,并分析相关的危险因素.方法 回顾性分析北京大学人民医院血液病研究所2009年10月至2010年8月异基因造血干细胞移植治疗的114例患者中,输注外周血干细胞24 h内新出现发热患者的临床资料.应用多因素logistic回归分析输注相关性发热的危险因素.结果 114例异基因外周血干细胞输注后24 h内共有32例(28.1％)患者出现发热,均为人类白细胞抗原(HLA)配型不相合的亲缘间移植.最高体温平均值为39.0(37.6～40.4)℃；出现发热的中位时间为输注后的2.5(0～18.0)h；体温达到峰值的中位时间为输注后7.8(3.5～23.0)h.发热病因分析:6例为感染性病因；26例排除溶血后归为输注相关性发热.多因素分析发现女性供者及供者采集当日外周血白细胞计数高是输注相关性发热的危险因素.结论 异基因外周血细胞输注后24h内新出现的发热均发生在HLA配型不相合亲属间移植患者,大多数与输注关系明显,无明确感染灶,其危险因素是女性供者及供者采集当日外周血白细胞高计数.
目的 探討接受異基因外週血榦細胞輸註後24h內患者新齣現髮熱的髮生率和病因,併分析相關的危險因素.方法 迴顧性分析北京大學人民醫院血液病研究所2009年10月至2010年8月異基因造血榦細胞移植治療的114例患者中,輸註外週血榦細胞24 h內新齣現髮熱患者的臨床資料.應用多因素logistic迴歸分析輸註相關性髮熱的危險因素.結果 114例異基因外週血榦細胞輸註後24 h內共有32例(28.1％)患者齣現髮熱,均為人類白細胞抗原(HLA)配型不相閤的親緣間移植.最高體溫平均值為39.0(37.6～40.4)℃；齣現髮熱的中位時間為輸註後的2.5(0～18.0)h；體溫達到峰值的中位時間為輸註後7.8(3.5～23.0)h.髮熱病因分析:6例為感染性病因；26例排除溶血後歸為輸註相關性髮熱.多因素分析髮現女性供者及供者採集噹日外週血白細胞計數高是輸註相關性髮熱的危險因素.結論 異基因外週血細胞輸註後24h內新齣現的髮熱均髮生在HLA配型不相閤親屬間移植患者,大多數與輸註關繫明顯,無明確感染竈,其危險因素是女性供者及供者採集噹日外週血白細胞高計數.
목적 탐토접수이기인외주혈간세포수주후24h내환자신출현발열적발생솔화병인,병분석상관적위험인소.방법 회고성분석북경대학인민의원혈액병연구소2009년10월지2010년8월이기인조혈간세포이식치료적114례환자중,수주외주혈간세포24 h내신출현발열환자적림상자료.응용다인소logistic회귀분석수주상관성발열적위험인소.결과 114례이기인외주혈간세포수주후24 h내공유32례(28.1％)환자출현발열,균위인류백세포항원(HLA)배형불상합적친연간이식.최고체온평균치위39.0(37.6～40.4)℃；출현발열적중위시간위수주후적2.5(0～18.0)h；체온체도봉치적중위시간위수주후7.8(3.5～23.0)h.발열병인분석:6례위감염성병인；26례배제용혈후귀위수주상관성발열.다인소분석발현녀성공자급공자채집당일외주혈백세포계수고시수주상관성발열적위험인소.결론 이기인외주혈세포수주후24h내신출현적발열균발생재HLA배형불상합친속간이식환자,대다수여수주관계명현,무명학감염조,기위험인소시녀성공자급공자채집당일외주혈백세포고계수.
Objective To investigate the incidence and pathogenesis of fever within the first 24 hours following allogeneic peripheral stem cell transfusion and to analyze the associated risk factors.Methods Totally 114 patients received allogeneic hematopoietic stem cell transplantation(allo-HSCT)between October 2009 and August 2010 were enrolled and clinical data of febrile patients within 24 hours following peripheral stem cell transfusion were retrospectively analyzed.Multivariate logistic regression analysis was performed to identify the risk factors for transfusion related fever.Results Thirty-two (28.1％)out of the 114 patients had a fever within 24 hours after allo-HSCT.All of them were human leukocyte antigen(HLA)mismatch transplantation.The median time of the temperature elevated was 2.5(0-18.0)hours after the infusion with a median time of the peak of 7.8(3.5-23.0)hours after the infusion.Fever was attributed to definite infection in 6 patients and no definite infection in the remaining 26 patients.None of them were hemolytic,which was attributed to transfusion related fever.Multivariate analysis showed that female donor and high count of peripheral leukocyte of donor peripheral blood were significant predictors for transfusion related fever.Conclusions Most of post-infusion fever within 24 hours after HLA mismatch related transplantation has no identifiable infectious focus.The risk factors for transfusion related fever are female donor and high number of peripheral leukocyte of donor blood.
