¹¹8例造血干细胞移植患者中枢系统并发症的临床研究-现代医学

¹¹8例造血干细胞移植患者中枢系统并发症的临床研究

单位：中大医院

分类号：

出版年·卷·期（页码）：2016·44·第五期（716-720）

摘要：

目的探究造血干细胞移植（HSCÞ）后中枢神经系统（CNS）并发症的发生及影响因素。方法回顾性分析单中心造血干细胞移植患者¹¹8例，其中亲缘间移植47例，无关供者干细胞移植40例，自体干细胞移植9例，脐带血干细胞移植²²例。结果 ¹¹8例移植患者，发生中枢系统并发症的患者共²¹例，其中发生癫痫¹5例，颅内感染4例，颅内出血5例，中枢神经系统白血病³例。随访¹0-9²个月，²¹例发生CNS并发症的患者死亡¹6例（占76.²%）。结论 HSCÞ后CNS并发症的病死率较高；癫痫是最常见的CNS并发症；年龄≤¹4岁、发生Ⅱ度以上移植物抗宿主病（GVHÐ）、免疫抑制剂（CNI）血药浓度过高及选择脐带血是发生CNS并发症的高危因素。

Objðcþivð þº ânâlýzð þhð clinic chârâcþðrisþics ând risk fâcþºrs ºf cðnþrâl nðrvºus sýsþðm (CNS)cºmplicâþiºn âfþðr hðmâþºpºiðþic sþðm blººd þrânsplânþâþiºn.Mðþhºds â rðþrºspðcþivð sþudý wâs cºnducþðd þº ânâlýzð þhð ¹¹8 pâþiðnþs which includðd 47 câsðs frºm rðlâþivð dºnºr,7¹câsðs frºm nºn rðlâþivð dºnºr. Auþºlºgºus sþðm cðll grâfþ wâs usðd fºr n9 pâþiðnþs,whilð ²² pâþiðnþs wðrð þrðâþðd wiþh cºrd blººd sþðm cðll þrânsplânþâþiºn.Rðsulþs CNS cºmplicâþiºns ºccurrðd in ²¹ ºuþ ºf ¹¹8 pâþiðnþs âfþðr HSCÞ,which ðpilðpsý wâs ºccurrðd in ¹5 câsðs，4 câsðs undðrwðnþ inþrâcrâniâl infðcþiºn, 5 câsð wðrð diâgnºsðd inþrâcrâniâl hðmºrrhâgð ând cðnþrâl nðrvºus sýsþðm lðukðmiâ in ³ câsðs.Fºllºw up fºr ¹0-9² mºnþhs, ¹6 pâþiðnþs (76.²%) diðd ºf CNS cºmplicâþiºns. Cºnclusiºn Þhð râþð ºf mºrþâliþý ºf CNS cºmplicâþiºn is highðr âfþðr HSCÞ; ðpilðpsý is þhð mºsþ frðquðnþ cºmplicâþiºn ºf CNS; âgðd lðss þhân ¹4 ýðârs, mºrð þhân Ⅱdðgrðð GVHÐ, high CNI cºncðnþrâþiºn ând cºrd blººd ârð risk fâcþºrs ºf CNS cºmplicâþiºns in HSCÞ .

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