预防输血相关性移植物抗宿主病发生的研究进展

Progress in the Prevention of Transfusion-associated Graft-versus-host Disease

输血是医疗救治的重要手段,但同时存在着多种并发症。输血相关性移植物抗宿主病(TA-GVHD)是其中之一,该病发生率为0.5%左右,死亡率却超过90%。由于TA-GVHD一旦发生,可逆转和治愈的几率低,所以TA-GVHD的预防显得尤为重要[1]。目前,预防TA-GVHD的主要方法有三种,一是利用白细胞过滤器进行去除白细胞后的输血[2];二是伽马血液辐照仪对血液制品进行伽马辐照,使血液制品中的T淋巴细胞失活,从而不再攻击人体[3];三是通过修改核酸,干扰病原体和白细胞的复制,抑制T淋巴细胞增殖。本文针对输血过程中可能发生的TA-GVHD,阐述了其发病机制、临床表现,着重探讨了目前预防TA-GVHD发生的三种方法,以期为减少TA-GVHD的发生提供参考。

Transfusion is an important means for medical treatment, but it has many syndromes such as transfusion- associated Graft- versus- host disease, its occurrence rate of 5‰ and above 90% death rate. Because of the difficulty in reversing TA-GVHD responses once they have been initiated, focus was placed on identifying approaches capable of preventing the onset of TA-GVHD. Nowadays, there are mainly three methods including leukocyte filter, gamma blood irradiator and pathogen inactivation to prevent TA-GVHD. This paper will summarize the clinical picture and treatment of TA-GVHD, and focus on the introduction of three prevention methods.