造血干细胞移植后人巨细胞病毒感染的相关性研究

摘要

Objective:To investigate the incidence of cytomegalovirus ( CMV ) infection and ganciclovir ( GCV ) resistance after hematopoietic stem cell transplantation( HSCT) ,and the correlation between CMV infection and graft-versus-host disease ( GVHD) .Methods:Eighteen patients undergone HSCT in our hospital were included between March 2012 and April 2014.Real-time fluorescent quantitative PCR(FQ-PCR) was performed to test the CMV in-fection in total patients,and patients with positive CMV-DNA were treated with GCV.Results:CMV infection occurred in 8 patients (44.4%),in whom 7 were umbilical cord blood transplantation(UCBT) from unrelated donors(87.5%,7/8).Seven in 8 with CMV infection were complicated with GVHD,in which 5 were infection of gradeⅢor over(71.4%,5 /7).GCV resistance after UCBT occurred in 2.Conclusion:HCMV infection and GCV resistance ap-pear higher in patients after UCBT,and incidence of GVHD is associated with HCMV.%目的：探讨分析造血干细胞移植（hematopoietic stem cell transplantation ，HSCT）后人巨细胞病毒（HCMV）感染与更昔洛韦（ganciclovir，GCV）耐药的发生及与移植类型、移植物抗宿主病（GVHD）等的相关性。方法：2012年3月～2014年4月在我院接受HSCT的患者18例，采用FQ－PCR法监测HCMV－DNA水平。 HCMV－DNA阳性患者给予GCV抢先治疗。结果：8例患者发生HCMV感染（44．4％），其中7例为不全相合无关供体脐血造血干细胞移植（UCBT）者。发生HCMV感染的8例患者中有7人出现GVHD，其中出现Ⅲ度及以上GVHD有5例（71．4％），均为UCBT者。 GCV耐药2例，均为UCBT后。结论：UCBT患者HCMV感染及GCV耐药高，GVHD与HCMV感染有关。