单倍型异基因造血干细胞移植后患者肺部真菌感染的临床研究

发布时间：2018-04-16 09:27

本文选题：单倍型 + 异基因造血干细胞移植　；参考：《中华医院感染学杂志》2015年13期

【摘要】：目的探讨单倍型异基因造血干细胞移植后肺部真菌感染的临床特点及治疗方法,为抗真菌治疗提供依据。方法对2010年1月-2013年1月医院血液科采用单倍型异基因造血干细胞移植治疗75例患者的临床资料进行回顾性研究,供者接受粒细胞集落刺激因子动员,采用骨髓加外周血干细胞联合移植,预处理方案以改良BUCY方案为主,移植后观察患者发生肺部真菌感染、并发症及疗效。结果 75例患者中12例发生肺部真菌感染,感染率为16.0%,2例通过支气管镜病理确诊,4例通过影像学及痰培养确诊,6例通过影像学、G试验及GM试验临床诊断;12例发生肺部真菌感染患者应用伏立康唑、卡泊芬净等一线抗真菌治疗后,6例治愈、6例死亡,肺部真菌感染患者病死率为50.0%。结论单倍型异基因造血干细胞移植后肺部真菌感染率、病死率高,应经验性选择抗真菌药物治疗。
[Abstract]:Objective to investigate the clinical features and treatment of pulmonary fungal infection after haplotype allogeneic hematopoietic stem cell transplantation.Methods the clinical data of 75 patients treated with haplotype allogeneic hematopoietic stem cell transplantation from January 2010 to January 2013 were retrospectively studied. The donors received granulocyte colony stimulating factor mobilization.Combined transplantation of bone marrow and peripheral blood stem cells was performed with modified BUCY regimen. Pulmonary fungal infection, complications and efficacy were observed after transplantation.Results Pulmonary fungal infection occurred in 12 of 75 patients.The infection rate was 16.0%, 2 cases were diagnosed by bronchoscopy, 4 cases were diagnosed by imaging and sputum culture, 6 cases were diagnosed by imaging G test and GM test, 12 cases of pulmonary fungal infection were diagnosed by Volconazole.After first-line antifungal therapy, 6 cases were cured and 6 cases died, and the mortality rate of pulmonary fungal infection was 50.0%.Conclusion the pulmonary fungal infection rate and mortality are high after haplotype allogeneic hematopoietic stem cell transplantation. Antifungal drugs should be selected empirically.
【作者单位】：北京军区总医院血液科;北京军区总医院院办;
【基金】：国家自然科学基金资助项目(31200686)
【分类号】：R457.7;R519

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