造血干细胞移植术后慢性肝脏移植物抗宿主病的危险因素

Study on risk factors of chronic liver graft-versus-host disease after hematopoietic stem cell transplantation

目的 研究造血干细胞移植(HSCT)术后肝脏慢性移植物抗宿主病(cGVHD)的危险因素。方法 回顾性分析2014年4月至2019年4月甘肃省第二人民医院收治的149例HSCT患者的一般资料,分析术后肝脏cGVHD发生情况,采用多因素logistic回归分析法分析HSCT术后并发肝脏cGVHD的独立影响因素。结果 149例HSCT患者中,患者术后发生肝脏cGVHD40例。多因素logistic回归分析显示,GVHD预防方案中加用ATG(OR=0.235,95%CI=0.113~0.490)、早期出现aGVHD(OR=2.089,95%CI=1.020~4.279)是HSCT患者术后肝脏cGVHD的独立影响因素(P<0.05)。结论 HSCT术后肝脏cGVHD的发生与移植早期出现aGVHD有关,而早期GVHD预防方案中加用ATG能降低其发生率。

Objective To study the risk factors of chronic graft-versus-host disease(cGVHD)in liver after hematopoietic stem cell transplantation(HSCT).Methods 149 patients with HSCT admitted to our hospital from April 2014 to April 2019 were enrolled in this study and retrospectively analyzed.General data of the patients were collected and postoperative liver cGVHD incidence was analyzed.Multivariate Logistic regression analysis was used to analyze the independent influencing factors of postoperative liver cGVHD complicated with HSCT.Results Among 149 patients with HSCT,40 patients had postoperative liver cGVHD,accounting for 26.85%;Liver cGVHD did not occur in 109 patients,accounting for 73.15%.Multivariate logistic regression analysis showed that the use of ATG(OR=0.235,95%CI=0.113~0.490)and early onset of aGVHD(OR=2.089,95%CI=1.020~4.279)were independent influencing factors of liver cGVHD after HSCT(P<0.05).Conclusion The occurrence of hepatic cGVHD after HSCT is related to the occurrence of cGVHD in the early stage of transplantation,and the use of ATG in the early prevention of GVHD can reduce the incidence.