中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
23期
10926-10929
,共4页
儿童%造血干细胞移植%生存质量
兒童%造血榦細胞移植%生存質量
인동%조혈간세포이식%생존질량
Children%Hematopoietic stem cell transplantation%Quality of life
随着造血干细胞移植(HSCT)技术、造血干细胞来源体系的不断完善及支持治疗的不断改进,移植成功率也在逐年上升,越来越多的儿童从 HSCT 中获得长期生存,造血干细胞移植后患儿的生存质量在近年来也逐渐被重视。针对 HSCT 患儿生存质量的研究在国内仍为空白,而国外学者通过各种量表研究发现:(1)HSCT患儿远期总体的生存质量(QOL)良好;(2)移植前后患儿QOL变化规律:移植前患儿的QOL已经下降,且预处理后会立即进一步下降,但移植4~24个月后会提高;(3)与非移植治疗的白血病患儿相比,HSCT白血病患儿有更多的晚期不良事件,QOL低于非HSCT患儿及正常儿童;(4) HSCT患儿QOL较公认的影响因素主要包括患儿的家庭功能、患儿本身的能力(如社会功能)以及是否存在慢性移植物抗宿主病(cGVHD),而多数研究显示移植时的年龄、性别、原发病、身高等不影响患儿的生存质量。需要指出的是,以上结论均是由国外研究得出,而我国HSCT治疗后患儿的QOL情况有待进一步研究。
隨著造血榦細胞移植(HSCT)技術、造血榦細胞來源體繫的不斷完善及支持治療的不斷改進,移植成功率也在逐年上升,越來越多的兒童從 HSCT 中穫得長期生存,造血榦細胞移植後患兒的生存質量在近年來也逐漸被重視。針對 HSCT 患兒生存質量的研究在國內仍為空白,而國外學者通過各種量錶研究髮現:(1)HSCT患兒遠期總體的生存質量(QOL)良好;(2)移植前後患兒QOL變化規律:移植前患兒的QOL已經下降,且預處理後會立即進一步下降,但移植4~24箇月後會提高;(3)與非移植治療的白血病患兒相比,HSCT白血病患兒有更多的晚期不良事件,QOL低于非HSCT患兒及正常兒童;(4) HSCT患兒QOL較公認的影響因素主要包括患兒的傢庭功能、患兒本身的能力(如社會功能)以及是否存在慢性移植物抗宿主病(cGVHD),而多數研究顯示移植時的年齡、性彆、原髮病、身高等不影響患兒的生存質量。需要指齣的是,以上結論均是由國外研究得齣,而我國HSCT治療後患兒的QOL情況有待進一步研究。
수착조혈간세포이식(HSCT)기술、조혈간세포래원체계적불단완선급지지치료적불단개진,이식성공솔야재축년상승,월래월다적인동종 HSCT 중획득장기생존,조혈간세포이식후환인적생존질량재근년래야축점피중시。침대 HSCT 환인생존질량적연구재국내잉위공백,이국외학자통과각충량표연구발현:(1)HSCT환인원기총체적생존질량(QOL)량호;(2)이식전후환인QOL변화규률:이식전환인적QOL이경하강,차예처리후회립즉진일보하강,단이식4~24개월후회제고;(3)여비이식치료적백혈병환인상비,HSCT백혈병환인유경다적만기불량사건,QOL저우비HSCT환인급정상인동;(4) HSCT환인QOL교공인적영향인소주요포괄환인적가정공능、환인본신적능력(여사회공능)이급시부존재만성이식물항숙주병(cGVHD),이다수연구현시이식시적년령、성별、원발병、신고등불영향환인적생존질량。수요지출적시,이상결론균시유국외연구득출,이아국HSCT치료후환인적QOL정황유대진일보연구。
As the improvement of the hematopoietic stem cell transplantation technology, hematopoietic stem cell sources system and support therapy, transplant success rate increased year by year. More and more children with serious hematological or non-hematological disease have achieved long-term survival due to the hematopoietic stem cell transplantation. Doctors have been paying more and more attention to the quality of life (QOL) in these survivors. In our country, the study about QOL after pediatric hematopoietic stem cell transplantation is still blank, while several foreign scholars have done a serial of researches and shown:(1) Children's overall long-term QOL was good after hematopoietic stem cell transplantation. (2) The trajectories of QOL pre-and post-transplantation: QOL was already compromised pre-transplant, further impaired immediately following conditioning, but improved 4-24 months post transplantation. (3) Pediatric leukemia patients post transplantation had more late effects and the QOL was significantly lower than the non-transplanted patients and healthy children. (4) The main proved influence factors included family functioning, individual resources (such as social skills) and cGVHD, while the majority of studies indicated that neither age at transplantation, gender, primary disease, nor stature influenced QOL significantly.