%0 Journal Article
%T 异基因造血干细胞移植后出血性膀胱炎的危险因素
%A 陈心传
%A 刘霆
%A 孟文彤
%A 贾永前
%A 李建军
%A 何川
%A 黄杰
%J 华西医学
%P 1767-1773
%D 2011
%X 【】　目的　分析异基因造血干细胞移植术（allogeneichematopoieticstemcelltransplantation，allo-HSCT）后出血性膀胱炎（hemorrhagiccystitis，HC）相关的危险因素，动态监测受者尿BK病毒（BKvirus，BKV），分析其与HC发病的关系。　方法　回顾性分析2003年3月-2008年1月期间接受allo-HSCT的121例患者的资料，选择8个临床参数年龄、性别、疾病类型、移植时疾病状态、供者类型、预处理方案、急性移植物抗宿主病（acutegraft-versus-hostdisease，aGVHD）、aGVHD的预防方案作COX回归分析。采用SYBRGreen染料实时荧光定量聚合酶链反应法对2006年9月-2008年1月42例allo-HSCT患者尿BKV载量进行动态监测，分析被检查者尿液BKV基因载量与HC发生以及严重程度的关系。　结果　121例患者中有24例发生HC，发病时间为术后0~63d，中位时间40d；持续时间7~150d，中位时间22d。Ⅱ~Ⅳ度aGVHD为HC的独立危险因素RR=8.304，95%CI（1.223，56.396），P=0.030。allo-HSCT受者尿液中BKV检出率为100%（42/42）。与正常人及未发生HC的allo-HSCT受者相比，HC患者尿中BKV基因载量具有更高平均峰值。　结论　Ⅱ~Ⅳ度aGVHD，尿中BKVDNA高载量与HC的发生有相关性。【Abstract】　Objective　Toidentifytheriskfactorsforhemorrhagiccystitis(HC)afterallogeneichematopoieticstemcelltransplantation(allo-HSCT),anddefinethequantitativerelationshipbetweenBKvirus(BKV)DNAloadwithHC.　Methods　Themedicalrecordsof121patientsundergoingallo-HSCTfromMarch2003toJanuary2008wereretrospectivelyanalyzed.EightclinicalparameterswereselectedforCOXregressionanalysis,includingage,sex,underlyingdisease,diseasestatusattransplant,donortype,conditioningregimen,acutegraft-versus-hostdisease(aGVHD),andGVHDprophylaxis.FromSeptember2006toJanuary2008,mid-streamurinesampleswerecontinuouslycollectedfrom42patientswithallo-HSCT.SYBRgreenreal-timepolymerasechainreaction,techniquewasutilizedtodefinethequantitativerelationshipbetweenBKVDNAloadandHC.　Results　Twenty-fouroutof121patientsdevelopedHC.Themediantimeofonsetwas40daysafterHSCT,rangedfrom0to63days.Thediseaselastedfor7to150days,withamediandurationof22days.GradeⅡ-ⅣaGVHDRR=8.304,95%CI(1.223,56.396);P=0.030wasidentifiedasanindependentriskfactorfortheoccurrenceofHC.BKVexcretionwasdetectedin100%(42/42)oftherecipientsofallo-HSCT.Whencomparedwithasymptomaticpatientsandallo-HSCTrecipientswithoutHC,patientswithHChadasignificantlyhighermeanpeakBKVDNAload.　Conclusions　PatientsareatanincreasedriskofdevelopingHCiftheyhavegradeⅡ-ⅣaGVHD.AcorrelationbetweentheloadofBKVandincidenceofHCmayexist.
%K 异基因造血干细胞移植
%K 迟发性出血性膀胱炎
%K BK病毒
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201112003