中国血液流变学杂志
中國血液流變學雜誌
중국혈액류변학잡지
CHINESE JOURNAL OF HEMORHEOLOGY
2015年
1期
47-51
,共5页
赵奇%周菊英%秦颂兵%郭建
趙奇%週菊英%秦頌兵%郭建
조기%주국영%진송병%곽건
造血干细胞移植%间质性肺炎%急性移植物抗宿主病%全身照射
造血榦細胞移植%間質性肺炎%急性移植物抗宿主病%全身照射
조혈간세포이식%간질성폐염%급성이식물항숙주병%전신조사
hematopoietic stem cell transplantation%interstitial pneumonitis%acute graft-versus-host disease%total body irradiation
目的：分析预处理方案中含全身照射（total body irradiation, TBI）的急性白血病患者造血干细胞移植（hematopoietic stem cell transplantation, HSCT）后发生间质性肺炎（interstitial pneumonia, IP）的相关因素。方法对139例HSCT预处理方案中含TBI的急性白血病患者资料进行回顾性研究，对可能影响IP发生的临床因素如移植前缓解状态、急性移植物抗宿主病（acute graft-versus-host disease, aGVHD）、移植方式、年龄、性别以及TBI参数如照射方案、剂量率、全身剂量均匀度采用单因素和多因素分析。结果单因素分析差异有统计学意义的相关因素为移植前缓解状态（χ2=5.213， P=0.022）、aGVHD（χ2=5.829，P=0.016）、照射方案（χ2=4.281，P=0.039），Logistic回归模型多因素分析，照射方案（P=0.042）、aGVHD（P=0.016）、移植前缓解状态（P=0.020）为移植后IP发生的显著相关因素。结论 HSCT后发生IP是多因素综合影响的结果，对移植前非首次完全缓解（The first complete remission, CR1）、行单次TBI方案预处理以及发生aGVHD的患者要高度重视IP的风险。
目的：分析預處理方案中含全身照射（total body irradiation, TBI）的急性白血病患者造血榦細胞移植（hematopoietic stem cell transplantation, HSCT）後髮生間質性肺炎（interstitial pneumonia, IP）的相關因素。方法對139例HSCT預處理方案中含TBI的急性白血病患者資料進行迴顧性研究，對可能影響IP髮生的臨床因素如移植前緩解狀態、急性移植物抗宿主病（acute graft-versus-host disease, aGVHD）、移植方式、年齡、性彆以及TBI參數如照射方案、劑量率、全身劑量均勻度採用單因素和多因素分析。結果單因素分析差異有統計學意義的相關因素為移植前緩解狀態（χ2=5.213， P=0.022）、aGVHD（χ2=5.829，P=0.016）、照射方案（χ2=4.281，P=0.039），Logistic迴歸模型多因素分析，照射方案（P=0.042）、aGVHD（P=0.016）、移植前緩解狀態（P=0.020）為移植後IP髮生的顯著相關因素。結論 HSCT後髮生IP是多因素綜閤影響的結果，對移植前非首次完全緩解（The first complete remission, CR1）、行單次TBI方案預處理以及髮生aGVHD的患者要高度重視IP的風險。
목적：분석예처리방안중함전신조사（total body irradiation, TBI）적급성백혈병환자조혈간세포이식（hematopoietic stem cell transplantation, HSCT）후발생간질성폐염（interstitial pneumonia, IP）적상관인소。방법대139례HSCT예처리방안중함TBI적급성백혈병환자자료진행회고성연구，대가능영향IP발생적림상인소여이식전완해상태、급성이식물항숙주병（acute graft-versus-host disease, aGVHD）、이식방식、년령、성별이급TBI삼수여조사방안、제량솔、전신제량균균도채용단인소화다인소분석。결과단인소분석차이유통계학의의적상관인소위이식전완해상태（χ2=5.213， P=0.022）、aGVHD（χ2=5.829，P=0.016）、조사방안（χ2=4.281，P=0.039），Logistic회귀모형다인소분석，조사방안（P=0.042）、aGVHD（P=0.016）、이식전완해상태（P=0.020）위이식후IP발생적현저상관인소。결론 HSCT후발생IP시다인소종합영향적결과，대이식전비수차완전완해（The first complete remission, CR1）、행단차TBI방안예처리이급발생aGVHD적환자요고도중시IP적풍험。
Objective To analyze factors related to interstitial pneumonia (IP) in patients with acute leukemia after hematopoietic stem cell transplantation (HSCT) and had received total body irradiation (TBI) as conditioning regimen.Methods 139 cases with acute leukemia after HSCT with TBI as conditioning regimen were studied retrospectively. Univariate and multivariate analysis were conducted of clinical factors that may affect the occurrence of IP such as remission before transplantation, acute graft-versus-host disease, transplantation way, age, sex, and TBI program parameters such as irradiation scheme, dose rate and the whole body dose uniformity. Results Remission before transplantation (χ2=5.213,P=0.022), acute graft-versus-host disease (aGVHD) (χ2=5.829,P=0.016), irradiation scheme (χ2=4.281,P=0.039) were statistically signifi cant factors by univariate analysis; irradiation scheme (P=0.042), aGVHD (P=0.016), remission before transplantation (P=0.020) were signifi cantly correlated factors by Logistic regression model analysis.Conclusion Occurrence of IP after HSCT is the result of the combined effects of multiple factors. Great importance should be attached to the risk of IP in patients with non-fi rst complete remission, single total body irradiation and occurrence of aGVHD.
