造血干细胞移植术后并发出血性膀胱炎的多因素研究

发布时间：2018-04-25 10:46

本文选题：造血干细胞移植术 + 出血性膀胱炎　；参考：《浙江中医药大学》2017年硕士论文

【摘要】：目的造血干细胞移植已成为治疗恶性血液病的有效手段,也是治愈某些血液病的唯一方法。而造血干细胞移植术后并发出血性膀胱炎的发病率较高,影响了患者的生存率。研究探讨造血干细胞移植术后并发出血性膀胱炎的危险因素,从而为预测出血性膀胱炎出现各种不良事件的可能性提供参考。方法对2014年6月-2016年10月在宁波市鄞州人民医院确诊血液系统恶性肿瘤并进行造血干细胞治疗的100例患者的临床资料进行回顾性分析。通过单因素和多因素Logistic回归分析筛选出与造血干细胞移植术后并发血性膀胱炎相关的危险因素;比较出血性膀胱炎组与非出血性膀胱炎组在年龄、性别、疾病类型、移植类型、预处理药物、预防GVHD的药物种类、CMV感染、BK病毒尿、aGVHD9个方面的差别。研究造血干细胞移植术后并发出血性膀胱炎的相关危险因素。结果造血干细胞移植与出血性膀胱炎发病情况:100例患者成功植入100例,其中有22例发生出血性膀胱炎发病率为22%。男性15例,女性7例。单因素分析表明,其中有3个危险因素与出血性膀胱炎的发生密切相关:(1)移植类型(X2=100.000;P0.001)(2)CMV 感染(X2=5.288;P=0.021)(3)BK病毒尿(X2=23.310;P0.001)。然后对上述中有统计学意义(P0.05)的危险因素进行Logistic多因素回归分析,只有BK病毒尿为出血性膀胱炎的危险因素(P0.05,OR=4.758)。在其他因素不变的情况下,患有BK病毒尿的人发生出血性膀胱炎的可能性是未患BK病毒尿的4.758倍。结论出血性膀胱炎是造血干细胞移植后的重要并发症,BK病毒尿是发生出血性膀胱炎的独立因素,危险性显著增加。
[Abstract]:Objective Hematopoietic stem cell transplantation (HSCT) has become an effective method for the treatment of malignant hematological diseases and the only way to cure some hematological diseases. The incidence of hemorrhagic cystitis after hematopoietic stem cell transplantation was high, which affected the survival rate of patients. To investigate the risk factors of haemorrhagic cystitis after hematopoietic stem cell transplantation (HSCT), and to provide a reference for predicting the occurrence of various adverse events in hemorrhagic cystitis. Methods the clinical data of 100 patients with hematopoietic stem cell therapy in Yinzhou people's Hospital of Ningbo City from June 2014 to October 2016 were analyzed retrospectively. The risk factors associated with hematopoietic cystitis after hematopoietic stem cell transplantation were screened by univariate and multivariate Logistic regression analysis, and the age, sex, disease type and transplant type were compared between hemorrhagic cystitis group and non-hemorrhagic cystitis group. Pretreatment of drugs to prevent GVHD from infecting BK virus in urine (AGV HD 9). To study the risk factors of hemorrhagic cystitis after hematopoietic stem cell transplantation. Results 100 cases of hematopoietic stem cell transplantation and hemorrhagic cystitis were successfully implanted in 100 cases, of which 22 cases developed hemorrhagic cystitis. There were 15 males and 7 females. Univariate analysis showed that three risk factors were closely related to the occurrence of hemorrhagic cystitis. The Logistic multivariate regression analysis showed that only BK virus urine was the risk factor of hemorrhagic cystitis. People with BK virus urine were 4.758 times more likely to develop hemorrhagic cystitis than those without BK virus urine, other factors being equal. Conclusion hemorrhagic cystitis is an important complication after hematopoietic stem cell transplantation.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R733;R694.3

【参考文献】