摘要
目的分析异基因造血干细胞移植(allo-HSCT)后慢性肝脏移植物抗宿主病的相关危险因素及预后。方法选取allo-HSCT后慢性肝脏移植物抗宿主病患者56例作为发生组,并以1∶1配比选取同期allo-HSCT后无慢性肝脏移植物抗宿主病患者56例作为未发生组。采用自制调查问卷收集两组性别、年龄、疾病状态、供体性别等信息,分析allo-HSCT后慢性肝脏移植物抗宿主病的相关危险因素及预后。结果患者年龄、人类白细胞抗原(HLA)配型是否相合、乙型肝炎表面抗原(HBsAg)表达、既往是否发生急性移植物抗宿主病(aGVHD)、移植前合并(心脏病、糖尿病)、是否加用抗胸腺细胞球蛋白(ATG)是影响allo-HSCT后慢性肝脏移植物抗宿主病的单因素(P<0.05);logistic回归分析显示,年龄>40岁、HBsAg表达阳性、既往发生aGVHD、移植前合并(心脏病、糖尿病)是allo-HSCT后慢性肝脏移植物抗宿主病的危险因素,HLA配型全相合、加用ATG是allo-HSCT后慢性肝脏移植物抗宿主病的保护因素(P<0.05)。发生组患者至随访完成,患者死亡15例,死亡率26.79%。结论allo-HSCT后慢性肝脏移植物抗宿主病影响因素较多,死亡率较高,临床应依据危险因素进行allo-HSCT后慢性肝脏移植物抗宿主病防治干预,以改善预后。
Objective To analyze the relevant risk factors and prognostic studies of chronic liver GVHD after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods 56 patients with chronic liver GVHD after allo-HSCT were selected as occurrence groups,and 56 patients without chronic liver GVHD after allo-HSCT were selected with 1∶1 ratio.Gender,age,disease status and donor sex of the 2 groups were collected using our homemade questionnaire,analyzed the risk factors and prognostic of chronic liver GVHD after allo-HSCT.Results Age,human leukocyte antigen(HLA)matching,hepatitis B surface antigen expression(HBsAg),previous acute graft versus host disease(aGVHD),merger before transplantation(heart disease,diabetes),and added anti-thymocyte globulin(ATG)were single factors affecting chronic liver GVHD after allo-HSCT(P<0.05);The logistic regression analysis showed that,Age>40,positive expression of HBsAg,and previous pre-transplant aGVHD,(heart disease,diabetes)were risk factors for chronic liver GVHD after allo-HSCT,Complete compatibility of HLA mating,plus ATG are protective factors for chronic liver GVHD after allo-HSCT(P<0.05).In the occurrence group until the completion of follow-up,15 patients died,with a mortality rate of 26.79%.Conclusion There are many factors of chronic GVHD and high mortality after allo-HSCT,and chronic GVHD intervention should be conducted based on risk factors to improve prognosis.
作者
李宣萱
翟岩
范慧
LI Xuanxuan;ZHAI Yan;FAN Hui(Henan Cancer Hospital,Zhengzhou,450000)
出处
《实用癌症杂志》
2022年第12期2054-2057,共4页
The Practical Journal of Cancer
