论文部分内容阅读
目的:探讨异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)后患者巨细胞病毒(cytomegalovirus,CMV)感染的发生率及其危险因素,为CMV感染的监测及治疗提供参考。方法:通过回顾性分析2011年12月至2014年12月在我院移植科行异基因造血干细胞移植患者398例,应用Kaplan Meier及Logistics回归模型,分析CMV感染的发生率及其发生的危险因素。结果:398例患者中233例发生CMV感染,累计发生率为58.5%。单因素分析表明,HLA不全相合,预处理过程中使用抗人免疫球蛋白(anti-human thymocyte globulin,ATG),发生急性移植物抗宿主病(graft-versus-host diseases,GVHD),泼尼松用量≥1 mg/kg与CM V感染发生率增加有关。多因素分析显示,HLA不全相合(HR=2.765,P=0.000),预处理过程中使用ATG(HR=3.866,P=0.000),泼尼松用量≥1 mg/kg(HR=4.767,P=0.000)使CMV感染的风险增加。结论:供/受者HLA不全相合,预处理过程中应用ATG,及治疗过程中泼尼松用量≥1 mg/kg都会增加患者CM V感染的发生率。
Objective: To investigate the incidence and risk factors of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in order to provide reference for the surveillance and treatment of CMV infection. Methods: By retrospective analysis of 398 cases of allogeneic hematopoietic stem cell transplantation in our hospital from December 2011 to December 2014, Kaplan Meier and Logistics regression models were used to analyze the incidence of CMV infection and its risk factors . Results: Of the 398 patients, 233 cases developed CMV infection with a cumulative incidence of 58.5%. Univariate analysis showed that HLA was not fully matched, and anti-human thymocyte globulin (ATG), graft-versus-host diseases (GVHD), prednisone The amount of ≥ 1 mg / kg and CM V infection increased incidence. Multivariate analysis showed that HLA was not fully matched (HR = 2.765, P = 0.000). Pretreatment with ATG (HR = 3.866, P = 0.000) and prednisone ≥1 mg / 0.000) increased the risk of CMV infection. CONCLUSIONS: Incompatibility of donor / recipient HLA, application of ATG during pretreatment, and prednisone ≥ 1 mg / kg during treatment may increase the incidence of CMV infection in patients.