原发性免疫缺陷病造血干细胞移植患儿几种常见呼吸道病毒病原分析

Several Common Respiratory Viral Pathogens in Hematopoietic Stem Cell Transplantion Patients with Primary Immunodeficiency Disease

目的:了解原发性免疫缺陷病(PID)患儿在造血干细胞移植过程中呼吸道病毒病原的感染情况。方法:选取2016年7月至2018年7月在血液肿瘤中心接受造血干细胞移植的PID患儿22例并收集其移植前、移植后鼻咽吸取物108份,采用RT-PCR方法检测呼吸道合胞病毒(RSV)、人偏肺病毒(hMPV)、冠状病毒(CoV)及副流感病毒1-3(PIV1-3),并分析其临床特征、协同感染等情况。结果:108份标本,41份检出病毒,检出率为37.96%。其中RSV检出率最高,为25.9%。不同类型的PID患者病毒感染率不同,其中感染率最高的是重症联合免疫缺陷(SCID)患儿,病毒检出率为57.9%。有2种或2种以上病毒协同感染的发生率为19.5%。结论:PID造血干细胞移植患儿更易发生呼吸道病毒感染,RSV是造血干细胞移植后重要的呼吸道病毒病原。

Objective:To investigate the prevalence of respiratory viral infections in patients with primary immunodeficiency disease(PID)during hematopoietic stem cell transplantation.Methods:108 specimens of nasopharyngeal aspirate were collected from 22 PID patients before and after hematopoietic stem cell transplantation from July 2016 to July 2018 in the Department of Hematology.The TR-PCR was used to detect for respiratory viruses including respiratory syncytial virus(RSV),human metapneumoviros(hMPV),coronavirus(CoV)and parainfluenza 1-3(PIV1-3).And the clinical characteristics and co-infection were analyzed.Results:Among the total 108 specimens,viral pathogens were identified in 41(37.96%)specimens.Among which the pathogens of highest detection rate was RSV(25.9%).Different types of PID showed different virus infection rates,among which the highest infection rate was severe combined immunodeficiency disease(SCID)patients,with the virus detection rate was 57.9%.The incidence of coinfection with two or more than two viruses was 19.5%.Conclusion:Patients with PID who undergo hematopoietic stem cell transplantation are more susceptible to respiratory viruses.RSV is an important respiratory tract virus pathogen after hematopoietic stem cell transplantation.