CAJ | 학술논문

目的：探讨异基因造血干细胞移植术后肺部感染的临床特征及危险因素。方法回顾分析2010～2012年收入该院的37例异基因造血干细胞移植患者的临床资料。结果17例患者异基因造血干细胞移植后发生33例次肺部感染，其中11例患者发生2次及以上的肺部感染，总发生率45．9％，直接死于肺部感染的有5例。仅39．4％（13/33）肺部感染有病原学证据，真菌感染尤其是白假丝酵母菌较为多见。单因素分析显示：肺部感染与供受者人类白细胞抗原（HLA）不全相合、移植物抗宿主病（GVHD）显著相关（P＝0．041、0．013），与其他因素无相关性（P＞0．05）。多因素分析显示：供受者HLA不全相合及GVHD与肺部感染显著相关（P＝0．041、0．021）。结论异基因造血干细胞移植术后肺部感染是常见并发症，对患者威胁较大。HLA不全相合及GVHD与移植后肺部感染显著相关。
목적：탐토이기인조혈간세포이식술후폐부감염적림상특정급위험인소。방법회고분석2010～2012년수입해원적37례이기인조혈간세포이식환자적림상자료。결과17례환자이기인조혈간세포이식후발생33례차폐부감염，기중11례환자발생2차급이상적폐부감염，총발생솔45．9％，직접사우폐부감염적유5례。부39．4％（13/33）폐부감염유병원학증거，진균감염우기시백가사효모균교위다견。단인소분석현시：폐부감염여공수자인류백세포항원（HLA）불전상합、이식물항숙주병（GVHD）현저상관（P＝0．041、0．013），여기타인소무상관성（P＞0．05）。다인소분석현시：공수자HLA불전상합급GVHD여폐부감염현저상관（P＝0．041、0．021）。결론이기인조혈간세포이식술후폐부감염시상견병발증，대환자위협교대。HLA불전상합급GVHD여이식후폐부감염현저상관。
Objective To investigate the clinical characteristics and risk factors of pulmonary infection after allogeneic hemato-poietic stem cell transplantation(allo-HSCT) .Methods The clinical data of 37 allo-HSCT patients treated in our transplantation u-nit from 2010 to 2012 were performed the retrospective analysis .Results Among 17 cases of allo-HSCT ,33 case-times of pulmona-ry infection occurred after transplantation ,in which more than twice pulmonary infection occurred in 11 cases ,the total occurrence rate of pulmonary infection was 45 .9% (17/37) .5 cases directly died of pulmonary infection .Only 39 .4% case-times of pulmonary infection had the pathogenic evidence .Fungal infection ,especially Candida albicans ,was predominant .The univariate analysis showed that pulmonary infection was significantly associated with human leucocyte antigen (HLA) non-identical of donor and recip-ient and graft versus host disease(GVHD)(P=0 .041 ,0 .013) ,and had no obvious correlation with the other factors (P>0 .05) . The multivariate analysis showed that the HLA non-identical of donor and recipient and GVHD were significantly associated with the occurrence of pulmonary infection (P=0 .041 ,0 .021) .Conclusion Postoperative pulmonary infection is a common complication following allo-HSCT ,which has larger threat to the patients .HLA non-identical and GVHD are significantly correlated with pulmo-nary infection after allo-HSCT .