异基因造血干细胞移植后肺部真菌感染13例临床分析

Clinical analysis of 13 cases with fungal pulmonary infectious after allogeneic hematopoietic stem cell transplantation

目的探讨异基因造血干细胞移植(allo-HSCT)后肺部真菌感染的发生情况。方法回顾性分析38例allo-HSCT患者肺部真菌感染的发生率、危险因素、治疗及其转归。结果 13例(34%)发生肺部真菌感染。患者年龄、供者性别、人类白细胞抗原(HLA)配型、预处理方式与术后肺部真菌感染无明显相关。急性移植物抗宿主病(aGVHD)、大剂量激素治疗、出院天数大于90d为肺部真菌感染发生的危险因素(P<0.05)。治愈率46%,2例死于真菌性肺炎。结论肺部真菌感染是allo-HSCT的严重并发症之一,与aGVHD、大剂量激素治疗、长时间的住院天数有关。

Objective To analyze the fungal pulmonary infection in the patients after allogeneic hematopoietic stem cell transplantation（allo-HSCT）.Methods Data of fungal pulmonary infection of 13 cases in 38 patients underwent allo-HSCT were analyzed to find out the incidence,risk factors,treatment and prognosis.Results Of 38 patients underwent allo-HSCT,13 patients occurred fungal pulmonary infection with a total incidence of 34%.The occurrence of fungal pulmonary infection was not closely associated with the age of the patients and donor′s gender,human leukocyte antigen（HLA） match and pretreatment.Acute graft-versus-host disease（aGVHD）,high-dose hormones and long time（more than 90 days） stay in hospital were the related risk factors for the occurrence of fungal pulmonary infection（P〈0.05）.Two patients died of transplant-related causes and the cure rate was 46%.Conclusion Fungal pulmonary infection is one of the most common complications after allo-HSCT.The aGVHD,high-dose hormones and long time stay in hospital may play important roles in fungal pulmonary infection.