异基因造血干细胞移植后肠球菌相关性腹泻的临床分析

Clinical analysis of enterococcus associated diarrhea in patients received allogeneic hematopoietic stem cell transplantation

目的:探讨异基因造血干细胞移植(allo-HSCT)后肠球菌相关性腹泻(EAD)的临床特点,分析原因,寻求有效的防治措施。方法:对36例allo-HSCT后EAD患者的临床资料进行回顾性分析,同时以36例健康人群作为对照组,观察EAD患者肠道菌群变化。同期行allo-HSCT者共70例,其中全相合移植40例,单倍体移植30例。结果:allo-HSCT后EAD患者肠道菌群中乳酸杆菌、双歧杆菌、类杆菌、肠杆菌等细菌数量明显下降,差异有统计学意义(P均<0.001)。全相合移植EAD发生率为40.0%,单倍体移植发生率为66.7%,差异有统计学意义(χ2=4.878,P=0.027)。EAD患者口服替考拉宁并辅助益生菌治疗均治愈。结论:EAD常见于allo-HSCT后,一旦出现应积极给予对症处理。

Aim：To explore clinical characteristics of enterococcus associated diarrhea （ EAD） in patients received allo-geneic hematopoietic stem cell transplantation （allo-HSCT）, analyze the corresponding causes and seek effective prevention and treatment measures .Methods：Retrospective analysis was performed in 36 EAD patients who had received allo-HSCT. And 36 healthy individuals with normal intestinal microflora were chosen as control group .The change of intestinal microflora in EAD patients was observed .Another 70 patients received allo-HSCT,among whom,40 were HLA all-matched transplanta-tion,and 30 were HLA haploidentical transplantation .Results：There was significant reduction in the counting of the intesti-nal flora such as Lactobacillus, Bifidobacterium, Bacteroides, and Enterobacter, etc（P〈0.001）.The EAD positive rate was 40.0%in HLA all-matched transplantation, and 66.7%in HLA haploidentical transplantation（χ^2 =4.878,P=0.027）.Oral administration of teicoplanin supplemented with probiotics could cure those patients with EAD .Conclusion： There is high occurrence of EAD for patients received allo-HSCT.Once that happens , patients should receive active treatment .