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异基因造血干细胞移植的中枢神经系统并发症危险因素分析 被引量:2

Analysis of the risk factors of central nervous system complications after allogeneic hematopoietic stem cell transplantation
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摘要 目的探讨异基因造血干细胞移植(allo—HSCT)后中枢神经系统(CNS)并发症的病因、临床特点及高危因素。方法观察68例allo—HSCT患者CNS并发症的发生情况及特点,并分析其原因和高危因素。结果69例患者allo—HSCT后6个月内8例发生CNS并发症,发生率11.6%。其中CNS并发症发生率在HLA,全相合及不全相合组分别为4.9%(2/41)和21.4%(6/28)(P〈0.05),在合并移植物抗宿主病(GVHD)≤2度和〉2度组分别为6.7%(4/9)、44.4%(4/60)(P〈0.01)。CNS并发症在年龄≤14岁和〉14岁组、用或未用抗人胸腺球蛋白组、疾病稳定或进展组、预处理含或不含白消安组各组内比较差异均无统计学意义(均P〉0.05)。allo—HSCT最常见的CNS并发症是癫痫和颅内感染,其次为颅内出血。结论allo.HSCT中HLA配型不全相合及发生GVHD〉2度均是发生CNS并发症的高危因素;癫痫、颅内感染和颅内出血是allo—HSCT常见的CNS并发症。 Objective To analyse the etiology, clinical characteristics and risk factors of central nervous system (CNS) complications after allogeneie hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical features of CNS complications in patients who underwent allo-HSCT were observed, and analysis its causes and risk factors. Results 8 cases of CNS complications oceured in 69 patients within 6 months after allo-HSCT and the incidence was 11.6 %, the occurrence rate of CNS complications was 21.4 % (6/28) in HLA mismatched group, higher than HLA matched group [4.9 % (2/41)] (P 〈 0.05). Analogously, the incidence was 44.4 % (4/60) in patients with graft-versus-host disease (GVHD) (〉grade 2), which was significantly higher than patients with 2 or below grade 2 GVHD [6.7 % (4/9)] (P 〈 0.01). But there was no significant difference in the incidence of CNS complications between ~〈 14 years old and 〉14 years old, with or without ATG, different stages of diseases, whether pretreatment with maryland respectively (P 〉 0.05), either. Epilepsy and intracranial infection were the most common CNS complications in allo-HSCT, followed by intraeranial hemorrhage. Conclusion HLA mismatched and above grade 2 GVHD are the risk factors of CNS complications in allo-HSCT. Epilepsy,intracranial infection and bleeding are common CNS complications in allo-HSCT.
出处 《白血病.淋巴瘤》 CAS 2012年第11期671-673,677,共4页 Journal of Leukemia & Lymphoma
关键词 造血干细胞移植 中枢神经系统 并发症 Hematopoietic stem cell transplantation Central nervous system Complications
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参考文献6

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