异基因造血干细胞移植后合并巨细胞病毒肺炎的临床分析

Clinical analysis of cytomegalovirus pneumonia after allogeneic hematopoietic stem cell transplantation

目的:分析异基因造血干细胞移植后巨细胞病毒(CMV)肺炎的临床特点。方法:回顾性分析2019年1月1日至2022年10月31日在郑州大学第一附属医院接受异基因造血干细胞移植后并发CMV肺炎的29例患者的临床资料。结果:29例中,确诊1例,临床诊断16例,拟诊12例。18例(62.1%)治疗有效,11例(37.9%)无效。无效组合并其他病原微生物感染(P=0.001)、移植物抗宿主病(P=0.005)及接受有创通气(P=0.018)患者比例大于有效组。结论:异基因造血干细胞移植后合并CMV肺炎确诊困难,治疗有效率低,需尽早明确诊断,尽早治疗。

Aim:To analyze the clinical characteristics of cytomegalovirus(CMV)pneumonia after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:Clinical features and laboratory data of 29 patients with CMV pneumonia after allo-HSCT from January 1,2019 to October 31,2022 at the First Affiliated Hospital of Zhengzhou University were collected.Results:Among the 29 patients,1 case with confirmed diagnosis,16 cases with clinical diagnosis,and 12 cases with suspected diagnosis;18(62.1%)were effective and 11(37.9%)were ineffective after treatment.The proportion of the patients with other pathogenic microorganism infection(P=0.001),graft-versus-host disease(P=0.005),and invasive ventilation(P=0.018)in ineffective group were higher than those in effective group.Conclusion:It′s difficult to diagnose definitely and treat CMV pneumonia after allo-HSCT.It′s necessary to clarify the diagnosis as soon as possible,so to receive effective treatment earlier.