干旱区生态环境知识资源中心(Arid): 异基因造血干细胞移植后患者腺病毒感染监测及临床意义

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	异基因造血干细胞移植后患者腺病毒感染监测及临床意义
其他题名	Clinical characteristics of Adenovirus infections and effective monitoring in patients undergoing allogeneic hematopoietic stem cell transplantation
	龙彦 1; 孙媛媛 1; 刘畅 1; 马寅婷 1; 贺春辉 2; 许兰平 3; 赵晓甦 3; 赵晓涛 1; 王辉 1
来源期刊	中华检验医学杂志
ISSN	1009-9158
出版年	2017
卷号	40 期号:2 页码:133-137
中文摘要	目的了解人腺病毒(HAdv)在异基因造血干细胞移植(allo-HSCT)后患者中的感染情况及临床特点,探讨allo-HSCT后进行HAdv监测的临床意义。方法按入选标准回顾性的纳入2012年10月至2014年8月在北京大学人民医院进行HAdv感染监测的allo-HSCT患者共845例,收集患者临床资料,采用实时荧光定量PCR(real-time PCR)法监测患者外周血HAdv载量,监测频率为1周2次(< 100 d)或进行必要时监测(> 100 d),同时对患者粪便、尿、肺泡灌洗液HAdv感染情况进行必要时监测,随访时间至少allo-HSCT后6个月,结合临床资料进行分析。结果共29例患者HAdv检测阳性,阳性率为3.4%(29/845),儿童(< 18岁)高于成人(≥ 18岁),分别为3.8%(6/ 155),3.3%(23/690)。allo-HSCT后在100 d内检出HAdv阳性占总阳性例数的72.4%(21/29)。外周血HAdv阳性的患者19例,粪便16例,尿9例,肺泡灌洗液阳性1例,其中有1例患者外周血、粪便和尿均为阳性。HAdv检出阳性的总体中位时间为69(13~ 189)d,粪便检出的中位时间56(53 ~ 144)d,早于外周血、尿。29例HAdv阳性患者中,17例合并巨细胞病毒血症,11例合并EB病毒血症,25例HAdv检测阳性前合并急性移植物抗宿主病(GVHD),4例合并慢性GVHD。临床以HAdv肠炎最为常见(14例),其次为出血性膀胱炎(7例),2例合并多器官损伤(>2个),1例为肺炎,8例患者临床死亡。结论HAdv是导致allo-HSCT后患者感染的重要病原体,且累及多器官,常合并巨细胞病毒和EB病毒感染,预后差,allo-HSCT后进行HAdv监测可指导临床及早治疗。
英文摘要	Objective To investigate the clinical characteristics of the human Adenovirus (HAdv) infections in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients and explore the clinical significance of HAdv monitoring. Methods A total of 845 cases underwent allo-HSCT were included retrospectively in Perking University People’s Hospital from October 2012 to August 2014. Peripheral blood HAdv load were monitored twice weekly within 100 days after allo-HSCT, or whenever necessary quantitatively by real-time PCR. Meanwhile, other clinical samples such as stool, urine, and bronchoalveolar lavage fluid (BLAF) were also detected qualitatively whenever necessary. The follow-up period was at least six months after allo-HSCT. All clinical data were collected and analyzed. Results The total positive rate of HAdv was 3.4% (29/845). The incidence of HAdv infection was higher in children [3.8% (6/155),< 18y] than that of adults [3.3% (23/690), ≥18y]. HAdv infection diagnosed within 100 days after allo-HSCT accounted for 72.4% (21/29) of the total number of positive cases. There were 19 cases detected positive in peripheral blood, 16 cases in stool, 9 cases in urine, and 1 oases in BLAF, respectively. One patient was positive in peripheral blood, stool and urine. The overall median time of HAdv was 69 (13 -189) d. The median time was 56 (53 - 144) d in stool, which was earlier than that of in peripheral blood, urine and stool. Among 29 cases of HAdv positive patients, 17 patients were coinfected with Cytomegalovirus (CMV) and 11 casess with Epstein-Barr virus (EBV). Twenty-five cases of HAdv were diagnosed with acute graft-versus-host disease (aGVHD) before HAdv infection, and 4 cases were diagnosed with chronic graft-versus-host disease (cGVHD). The most common clinical manifestation was HAdv enteritis (14 cases),followed by hemorrhagic cystitis(7 cases). Two cases complicated with multiple organ injury (> 2) clinically,1 cases with pneumonia. There were 8 cases of death at the end of follow-up. Conclusions HAdv is an important pathogen causing infection in patients after allo-HSCT. The infenction is characterized with multiple organ involvement. CMV and EBV coinfection is common. HAdv monitoring was of great significance in allo-HSCT patients.
中文关键词	腺病毒感染,人 ; 造血干细胞移植 ; 移植,异基因
英文关键词	Adenovirus infections,human Hematopoietic stem cell transplantation Transplantation,allogene
语种	中文
国家	中国
收录类别	CSCD
WOS类目	MEDICINE GENERAL INTERNAL
WOS研究方向	General & Internal Medicine
CSCD记录号	CSCD:5925686
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/237215
作者单位	1.北京大学人民医院检验科, 100044; 2.江西省新钢中心医院; 3.北京大学人民医院北京大学血液病研究所, 100044
推荐引用方式 GB/T 7714	龙彦,孙媛媛,刘畅,等. 异基因造血干细胞移植后患者腺病毒感染监测及临床意义[J],2017,40(2):133-137.
APA	龙彦.,孙媛媛.,刘畅.,马寅婷.,贺春辉.,...&王辉.(2017).异基因造血干细胞移植后患者腺病毒感染监测及临床意义.中华检验医学杂志,40(2),133-137.
MLA	龙彦,et al."异基因造血干细胞移植后患者腺病毒感染监测及临床意义".中华检验医学杂志 40.2(2017):133-137.