【摘要】 目的:探讨预防治疗及预先治疗对异基因造血干细胞移植后CMV感染的干预作用。方法:225例异基因造血干细胞移植患者中160例接受预先治疗,65例接受预防治疗,用logistic回归模型分析影响CMV感染的危险因素。结果:预先治疗组与预防治疗组比较,CMVpp65抗原血症、CMV病和CMV病死亡率分别为28.1%(35.3%,P>0.05)、1.9%(12.3%,P<0.05)和0.6%(10.7%,P<0.01)。单倍体相合移植组出现CM-Vpp65血症33.0%(40.0%,P>0.05)、CMV病发生率1.9%(12.0%,P<0.05)、死亡率0.0%(10.0%,P<0.05),均低于相合移植。单倍体相合移植组中CMVpp65阳性发生的主要危险因素为重症GVHD、移植前给予抗CMV治疗以及是否混合其他严重感染。结论:异基因移植后预先治疗优于预防治疗,可以明显减低CMV病的发生和死亡。更多还原

【Abstract】 Objective:To explore the impact of pre-emptive therapy and prosphylactic therapy on CMV infection in allogeneic HSCT. Method:160 of 225 patients receiving allogeneic HSCT were given pre-emptive therapy while 65 patients were given prosphylactic therapy. Risk factors of CMV infection were investigated by logistic regression analysis. Result:CMV pp65 antigenemia rate, CMV disease rate and death rate were 28.1%, 1.9% and 0.6% in pre-emptive therapy group, but much lower in prosphylactic therapy group (35.3%,P>0.05;12.3%,P<0.05;10.7%,P<0.05, respectively).CMV pp65 antigenemia rate in HLA haploidentical matched group was higher than that in matched group. Main risk factors were severe GVHD, pre-emptive therapy against CMV and concurrent severe infection. Conclusion:Pre-emptive anti-CMV treatment was better than prosphylactic therapy after HSCT, which could decrease the occurrence and death rate of CMV disease.更多还原