| 异基因造血干细胞移植患者T细胞亚群数量与侵袭性真菌感染关系的临床研究 |
| 投稿时间：2010-12-11 修订日期：2011-02-17 点此下载全文 |
| 引用本文：曲红,孙竞,刘启发,徐丹,张钰,范志平,叶昌雄.异基因造血干细胞移植患者T细胞亚群数量与侵袭性真菌感染关系的临床研究[J].医学研究杂志,2011,40(11):128-132 |
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| 中文摘要:目的回顾性分析异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation，allo-HSCT）患者T淋巴细胞亚群免疫重建与侵袭性真菌感染（invasive fungal infections，IFI）相关性。方法通过观察移植后T淋巴细胞亚群重建特点，比较真菌易感者与非易感者之间T淋巴细胞亚群数量间的差异，探讨移植后T淋巴细胞亚群数量与真菌易感性的关系。结果①移植后中位随访时间为29（5~45）个月。移植后出现IFI的患者57例（44.9%），首次IFI发生的中位时间为23（1~702）天；②CD8+T淋巴细胞重建明显早于CD4+T淋巴细胞；③真菌易感组与非易感组移植后12个月CD3+T淋巴细胞比例值间有统计学差异（P=0.034），但其预测真菌易感性却无统计学意义（P=0.072）；移植后真菌易感组与非易感组间T淋巴细胞亚群绝对值均无统计学意义，考虑与病例数较少有关。结论①尽可能避免IFI各种高危因素，并采取积极有效的预防措施，减低IFI发生率及病死率；②移植后12个月CD3+T淋巴细胞比例值减少的患者易发生真菌感染，其可一定程度预测真菌易感性。 |
| 中文关键词:异基因造血干细胞移植 免疫重建 侵袭性真菌感染 |
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| Relationship between T Lymphocyte Reconstitution and Invasive Fungal Infections in Allogeneic Hematopoietic Stem Cell Transplant Recipients |
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| Abstract:ObjectiveWe designed a retrospectively study that analysed the risk factors for invasivefungal infections（IFI）, the characteristic ofT lymphocyte reconstitution and the relationship between T lymphocyte reconstitution and IFI in patients after allogeneic hematopoietic stem cell transplantation. Therefore, we could prognosticate the incidence of IFI after allogeneic hematopoietic stem cell transplantation, and administer the high risk patients with timely and appropriate pre-emptive treatment.Methods127 allo-HSCT patients were selected from hematology department of nanfang Hospital affiliated to Southern Medical University from January 2002 to August 2006, of which there were 80 males and 47 females with the median age of 30 (11-50).There were 22 cases with IFI or having history of IFI before allogeneic hematopoietic stem cell transplantation,105 patients without IFI.Results①The median visiting period was 29 months(5-45).IFI occurred in 57 (44.9%) patients.The median time of the first IFI occurred was 23 days (1-702).②Reconstruction of CD8+T lymphpcytes was significantly earlier than CD4+ T lymphocytes.③CD3+T-cells were significantly different between fungal susceptible group and non-susceptible ones after transplantation(P=0.034),but there was no statistically significant prediction(P=0.072). T lymphocyte subsets were not statistically significant between fungal susceptible group and non-susceptible ones after transplantation.Conclusion①We should avoid various risk factors of IFI and take positive and effective preventive measure to reduce the indicent and mortality of IFI as far as possible.②Patients with reducing CD3+ T lymphocytes prone to fungal infections 12 months after allo-HSCT,It and can predict fungal susceptibility to some extent. |
| keywords:Allogeneic hematopoietic stem cell transplantation Immune reconstitution T lymphocyte subsets Invasive fungal infections |
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