中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2015年
5期
389-392
,共4页
徐静%陈广华%宋铁梅%朱子玲%冯宇锋%常惠荣%陈峰%马骁%吴德沛
徐靜%陳廣華%宋鐵梅%硃子玲%馮宇鋒%常惠榮%陳峰%馬驍%吳德沛
서정%진엄화%송철매%주자령%풍우봉%상혜영%진봉%마효%오덕패
造血干细胞移植%巨细胞病毒%重激活%细支气管炎,闭塞性
造血榦細胞移植%巨細胞病毒%重激活%細支氣管炎,閉塞性
조혈간세포이식%거세포병독%중격활%세지기관염,폐새성
Hematopoietic stem cell transplantation,allogeneic%Cytomegalovirus reactivation%Bronchiolitis obliterans
目的 探讨异基因造血干细胞移植(allo-HSCT)术后CMV重激活与闭塞性细支气管炎(BO)的相互关系.方法 2011年1月至2013年12月行allo-HSCT的769例患者,通过荧光定量PCR方法检测CMV-DNA水平,免疫荧光染色白细胞PP65抗原血症两种检测方法诊断CMV感染,将CMV感染患者出现BO与未发生CMV感染患者出现BO进行比较,分析CMV感染与BO相关性,并将符合CMV感染患者中出现BO与未出现BO者进行对照分析.结果 诊断CMV感染259例患者中出现BO 32例(12.35％),而未感染CMV的510例患者发生BO 8例(1.56％),二者差异有统计学意义(P＜0.001).将诊断CMV感染259例患者,发生BO 32例与未发生BO 227例的二组临床资料进行CMV相关临床分析比较.CMV病毒载量在105拷贝数/ml较低病毒载量102拷贝数/ml出现BO差异有统计学意义.结论 在allo-HSCT后导致BO的风险因素中,CMV感染是值得注意的相关因素之一,其中高病毒载量和CMV重激活和CMV肺炎是可能危险因素.
目的 探討異基因造血榦細胞移植(allo-HSCT)術後CMV重激活與閉塞性細支氣管炎(BO)的相互關繫.方法 2011年1月至2013年12月行allo-HSCT的769例患者,通過熒光定量PCR方法檢測CMV-DNA水平,免疫熒光染色白細胞PP65抗原血癥兩種檢測方法診斷CMV感染,將CMV感染患者齣現BO與未髮生CMV感染患者齣現BO進行比較,分析CMV感染與BO相關性,併將符閤CMV感染患者中齣現BO與未齣現BO者進行對照分析.結果 診斷CMV感染259例患者中齣現BO 32例(12.35％),而未感染CMV的510例患者髮生BO 8例(1.56％),二者差異有統計學意義(P＜0.001).將診斷CMV感染259例患者,髮生BO 32例與未髮生BO 227例的二組臨床資料進行CMV相關臨床分析比較.CMV病毒載量在105拷貝數/ml較低病毒載量102拷貝數/ml齣現BO差異有統計學意義.結論 在allo-HSCT後導緻BO的風險因素中,CMV感染是值得註意的相關因素之一,其中高病毒載量和CMV重激活和CMV肺炎是可能危險因素.
목적 탐토이기인조혈간세포이식(allo-HSCT)술후CMV중격활여폐새성세지기관염(BO)적상호관계.방법 2011년1월지2013년12월행allo-HSCT적769례환자,통과형광정량PCR방법검측CMV-DNA수평,면역형광염색백세포PP65항원혈증량충검측방법진단CMV감염,장CMV감염환자출현BO여미발생CMV감염환자출현BO진행비교,분석CMV감염여BO상관성,병장부합CMV감염환자중출현BO여미출현BO자진행대조분석.결과 진단CMV감염259례환자중출현BO 32례(12.35％),이미감염CMV적510례환자발생BO 8례(1.56％),이자차이유통계학의의(P＜0.001).장진단CMV감염259례환자,발생BO 32례여미발생BO 227례적이조림상자료진행CMV상관림상분석비교.CMV병독재량재105고패수/ml교저병독재량102고패수/ml출현BO차이유통계학의의.결론 재allo-HSCT후도치BO적풍험인소중,CMV감염시치득주의적상관인소지일,기중고병독재량화CMV중격활화CMV폐염시가능위험인소.
Objective To investigate the correlation between CMV reactivation and obliterative bronchiolitis (BO) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods From January 2011 to December 2013,769 patients underwent allo-HSCT.The CMV infection was diagnosed by fluorescence quantitative PCR method for detecting the level of CMV-DNA and immunofluorescence staining of PP65 antigen in white blood cell.The frequency of BO in patients with and without CMV infection was compared,and the correlation between CMV infection and BO was analyzed.The clinical data of CMV infection patients with and without BO were analyzed and compared.Results Of 259 diagnosed CMV infection patients,BO occurred in 32 cases,the incidence rate was 12.35％,while in 510 cases without CMV infection,BO occurred in 8 cases,the incidence was 1.56％.The incidence rate of BO is significantly higher in patients with CMV infection than that in patients without CMV infection (P＜ 0.001).The CMV related clinical data between the 32 cases with BO and 227 cases without BO were analyzed among the 259 cases of diagnosed CMV infection patients.BO incidence is higher in patients with more than 105 copies/ml CMV-DNA than that in patients with less than 102 copies/ml CMV-DNA.Conclusion Among the risk factors related to BO post allo-HSCT,CMV infection is one of them to be worthy of attention.CMV reactivation with high virus titer,multiple CMV reactivations and CMV pneumonia are the risk factors.
