蛇毒血凝酶治疗异基因造血干细胞移植后重度出血性膀胱炎效果观察

Efficacy observation of hemocoagulase for the treatment of severe hemorrhagic cystitis following allogeneic hematopoietic stem cell transplantation

目的：探讨蛇毒血凝酶治疗异基因造血干细胞移植（HSCT）后重度出血性膀胱炎（HC）的临床效果。方法20例接受异基因HSCT的患者在移植后14～70 d发生重度HC，接受蛇毒血凝酶（静脉滴注1 U／次，1次／12 h，＆#215;5 d）治疗。蛇毒血凝酶治疗前、后分别留取尿液标本，通过肉眼观察和显微镜检查评定疗效。结果20例重度HC患者接受蛇毒血凝酶治疗后，18例达到治愈，肉眼血尿消失中位时间为应用蛇毒血凝酶后28 d（4～127 d），1例有效，1例无效。20例患者均未出现严重并发症。结论蛇毒血凝酶治疗HSCT后重度HC安全、有效。

Objective To investigate the clinical efficacy of hemocoagulase for severe hemorrhagic cystitis （HC） following allogeneic hemotopoietic stem cell transplantation （HSCT）. Methods Twenty patients undergoing allogeneic HSCT developed severe HC with an onset time of 14 to 70 days, all patients received the treatment of hemocoagulase （1 U ivgtt q12 h×5 d）. The urine speciments reserved before and after hemocoagulase were examined by naked eye and microscope to evaluate the efficacy. Results Twenty patients received the treatment of hemocoagulase. The HC was cured in 18 patients, improved in 1 patient and uncontrolled in 1 patient. For the patients with response, macroscopic hematuria disappeared at a median of 28 days （4-127 days） after the treatment. All procedures were tolerated well and no severe adverse effect was observed. Conclusion Hemocoagulase seems to be a safe and effective drug for severe HC following HSCT.