摘要
目的探讨治疗恶性血液病异基因造血干细胞移植(allo-HSCT)后肺部并发症与相关危险因素的关系。方法回顾性分析1991年8月至2004年6月157例allo-HSCT患者的临床资料。结果71例患者发生87例次肺部并发症,其中15例患者发生2次以上肺部并发症,总发生率为45.2%,直接死于肺部并发症者37例(23.6%),发生中位时间103d(1～886d)。其中细菌性肺炎32例,间质性肺炎8例,肺真菌病3例,肺水肿3例,肺结核2例,肺栓塞1例,2种或2种以上病原所致的肺部并发症38例次。单因素分析显示:患者年龄、疾病状态、供受者关系、HLA配型相合程度及广泛型慢性移植物抗宿主病(cGVHD)是影响移植后肺部并发症的危险因素。多因素分析显示:疾病状态和广泛型cGVHD与肺部并发症的发生显著相关(P<0.01)。结论肺部并发症是allo-HSCT后常见的并发症之一。患者移植时疾病状态和广泛型cGVHD是与allo-HSCT后肺部并发症发生相关的危险因素。
Objective To study the relation of the incidence, risk factors and pathogenesis of pulmonary complications（PC） occurred after allogeneic hematopoietic stem ceil transplantation（allo-HSCT） for treating malignant hematopathy. Methods The clinical data of 157 cases of alIo-HSCT during August, 1991 to June, 2004 were analyzed retrospectively. Result Eighty-seven PC episodes were observed in 71 patients,including 15 cases with more than two times, the total incidence was 45.2 %. The overall mortality for PC was 23.6 %（37/157）, the mean time of PC development was 103 days（1 ～ 886 days） after alIo-HSCT. Most of PC were due to infections, including bacterial pneumonia（n = 32）,interstitial pneumonia（n = 8）,pulmonary fungus disease （n = 3）,pulmonary edema（n = 3）,tuberculosis（n = 2）,pulmonary embolism（n = 1） and 38 episodes caused by two or more pathogens. By univariate analysis, age,the status of disease,relation between donor and recipient,HLA mismatch and chronic extensive graft-versus-host disease（cGVHD） were closely associated with the occurrence of PC. By multivariate analysis,only the status of disease and cGVHD were significantly associated with the occurrence of PC （P 〈 0.01 ）. Conclusion PC is one of most common complications after alIo-HSCT. The status of disease and extensive cGVHD are independent risk factors for PC.
出处
《生物医学工程与临床》
CAS
2007年第2期129-133,共5页
Biomedical Engineering and Clinical Medicine
关键词
异基因造血干细胞移植
肺部并发症
移植物抗宿主病
allogeneic hematopoietic stem cell transplantation
pulmonary complication
graft-versus-host disease
