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异基因造血干细胞移植后带状疱疹的临床分析
Clinical analysis on herpes zoster in patients with allogenic hematopoeitic stem cell transplantation
【摘要】 目的探讨异体基因造血干细胞移植(allo-HSCT)后带状疱疹的发病情况、临床特点、诊治及预后。方法对河南省肿瘤医院血液科allo-HSCT受者带状疱疹的发生时间、临床表现、治疗及预后进行回顾性分析。结果可评估的191例接受allo-HSCT患者中有18例并发带状疱疹,发病率为9.42%,其中14例发生在干细胞移植治疗后3~12个月内。10例合并慢性移植物抗宿主病(GVHD),1例合并急性GVHD。临床表现主要为区域性皮肤疱疹。3例出现严重疱疹后神经痛,需强效止痛。无泛发性疱疹及内脏受累病例。所有患者接受抗病毒药物阿昔洛韦和阿糖腺苷静脉输注治疗,全部治愈,无疱疹相关死亡患者,平均治疗时间为15.5 d。结论带状疱疹是allo-HSCT后常见的病毒感染性疾病,主要发生在干细胞移植治疗后3~12个月,GVHD是其发生的高危因素。阿昔洛韦和阿糖腺苷的疗效较好。
【Abstract】 Objective To investigate the incidence,characteristics,treatment,and outcomes of varicella-zoster virus(VZV) infection in patients after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The data of patients complicated with VZV after allo-HSCT in our hospital with emphasis on clinical date,treatments,clinical manifestations,follow-up results were analyzed,retrospectively.Results Total of 18 patients(9.42%) among the 191 evaluated patients were complicated with VZV infection after allo-HSCT,14 of which(77.78%) had VZV infection during 3-12 months after allo-HSCT.Among the 18 patients with VZV,10 patients occured chronic graft versus host disease(GVHD) and 1 with acute GVHD. Characteristic vesicular skin lesions occurred in a dermatomal distribution in all cases.Three patients developed severe neuralgia and required powerful pain relief.No patient had herpetic dissemination and visceral involvement.All cases were treated with acyclovir and/or arabinosyl adenine through intravenously for 15.5 days averagely.No patient died of VZV infection.Conclusions VZV infection was common in patients after allo-HSCT,which occurred during 3-12 months after treatment.GVHD was a high risk factor to VZV infection.acyclovir and arabinosyl adenine were effective drugs.
【Key words】 Hematopoietic stem cell transplantation; Herpesvirus 3,human; Immunosuppressive agents;
- 【文献出处】 中华实验和临床感染病杂志(电子版) ,Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition) , 编辑部邮箱 ,2012年03期
- 【分类号】R752.12
- 【被引频次】1
- 【下载频次】83