HLA配型不合造血干细胞移植术后免疫功能重建及其与发生感染的关系

Clinical study on immune reconstitution and infection after HLA-mismatched hematopoietic stem cell transplantation

目的观察HLA配型不合造血干细胞移植术后免疫功能重建及感染的情况。方法选择14例接受HLA配型不合造血干细胞移植患者,分别以淋巴细胞亚群、血清球蛋白含量、移植后感染的情况为观察指标,监测移植后免疫功能与感染的关系。结果患者移植后表现为CD4+和CD19+长期的减少,CD4+/CD8+的持续倒置,IgA恢复最慢。移植后1个月内感染率高,6个月后感染发病率减少。结论HLA配型不合造血干细胞移植术后患者免疫功能的恢复需要数月至数年的时间,控制间质性肺炎及重症感染是降低感染病死率的关键。

Objective To observe the immune reconstititution and the infection condition after HLA-mismatched hernatopoietic stern cell transplantation. Methods Forteen patients accepted the transplantation, and the lymphocytes immunity pheocyte, serum globulin level and infection states were analyzed. Results CD4^＋ ana CD19^＋ obviously decreased and CD4^＋/CD8^＋ continuously inversed. IgA level 2ecovered slowly. Infection rate at the first stage after transplatation was high and was decreaasesd 6 months later. Conclusion After HLA-mismatched hematopoietic stern cell transplanta- tion the recovery of immune function of the patients needs months to yeans. The key for reducing death rate after infection is to control interstitial pneumonia and severe infection.