【摘要】 目的探讨造血干细胞移植后带状疱疹发病情况、临床特点、治疗及转归。方法回顾分析浙江省中医院血液科可评估的104例接受造血干细胞移植患者预处理方案、移植物抗宿主病预防方案及病毒感染的防治方案等临床资料。结果104例接受造血干细胞移植患者中有24例(23.08%)并发带状疱疹,其中单倍体相合造血干细胞移植患者带状疱疹发生率为47.6%,非亲缘造血干细胞移植患者带状疱疹发生率为42.1%。应用抗病毒药物,适当减少免疫抑制剂用量及输注人免疫球蛋白,外用干扰素,同时中医中药辅助治疗,平均治疗(20.5±3.8)d后,患者疱疹全部消退,有4例出现严重疱疹后神经痛,其中2例伴有局部肌肉萎缩。无泛发性疱疹及内脏受累病例,无疱疹相关死亡。结论造血干细胞移植后发生的带状疱疹起病不典型,综合治疗能够有效地控制,但神经痛持续时间较长。更多还原

【Abstract】 Objective To analyze the incidence,characteristics,treatment,and outcomes of herpes zoster infection in patients after hematopoitic stem cell transplantation (HSCT).Methods One hundred and four patients who underwent HSCT from May 1995 to May 2008 were studied retrospectively to explore the conditioning regimen,prevention of graft-versus-host disease,and prophylaxis and treatment associated with herpes zoster infections.Results Twenty-four patients (23.08%) developed herpes zoster infection after transplant,with an incidence high to 47.6% in haploidentical bone marrow transplnatation patients and 42.1% in unrelated-donor bone marrow transplantation patients.Combined treatment with antivirus drugs,reduction of immunosuppressant dosages,infusion of immunoglobulin,and interferon for external use,as well as traditional Chinese medicine as adjuvant therapy was applied,with a mean treatment time of (20.5±3.8) days.Herpes subsided in all patients,but 4 patients developed severe neuralgia and required powerful pain relief and another 2 accompanied by localized muscle atrophy.No patients had visceral dissemination and involvement.No death from herpes zoster infection was covered.Conclusion Symptoms and signs of herpes zoster infection after HSCT is atypical.Herpes can be effectively managed by comprehensive therapy,but neuralgia may last long after the treatment.更多还原