摘要
目的回顾性分析异基因造血干细胞移植(Allo-HSCT)后100d内腹泻的临床特点及病因谱。方法总结北京大学人民医院2006年9月至2007年3月125例Allo-HSCT患者移植后100d内的资料。结果76例发生移植后腹泻的患者累计发病114例次,总发生率60.8%(76/125)。病因分析显示,预处理毒性62例次(54.4%),急性移植物抗宿主病(aGVHD)32例次(28.1%),感染性腹泻15例次(13.2%),血栓性微血管病(TMA)及植入综合征各2例次,治疗相关性腹泻1例次。76例移植后腹泻治愈72例,死亡4例(5.3%)。Cox回归分析显示,HLA配型不合(R=6.643,P=0.026)及高危疾病状态(R=3.749,P=0.001)是腹泻发生的危险因素。结论腹泻是Allo-HSCT后的常见症状,其病因包括感染和非感染因素,针对病因的治疗可以改善预后。
Objective To retrospectively analyze the etiology and clinical features of diarrhea post allogeneic haemopoietic stem cell transplantation (allo-HSCT). Methods Analysis was made of 125 allo-HSCT recipients in Pekin university people's hospital during Sep 2006 to Mar 2007. Results 114 episodes of diarrhea occurred in 76 patients with the morbidity of 60. 8% ( 76/125 ). 62 epsiodes ( 54. 4% ) were caused by conditioning regimen ; 32 episodes ( 28. 1% ) were caused by intestinal acute graft-versus-host disease (aGVHD) ;15 episodes (13.2%) were caused by intestinal infection;2 episodes were caused by thrombotic mieroangiopathy (TMA) and engraftment syndrome respectively;in addition, 1 episode was caused by treatment. 72 patients with episodes of diarrhea were cured and 4 patients (5.3%) died. HLA mismatching (R = 6. 643 ,P = 0. 026 ) and patients with high risk (R = 3. 749 ,P = 0. 001 ) were determined to be risk factors for episodes of diarrhea by cox regression analysis. Conclusion Diarrhea is common symptom in allo-HSCT recipients, of which etiology includes infection and non-infection. Its clinical outcome could be improved by specific therapy.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2009年第7期622-625,共4页
Chinese Journal of Practical Internal Medicine
关键词
腹泻
异基因造血干细胞移植
急性移植物抗宿主病
diarrhea
allogeneic haemopoiefic stem cell transplantation
acute graft-versus-host disease