本文選題：造血干細胞移植術 + 巨細胞病毒��； 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討阿昔洛韋緩釋片預防骨髓異基因造血干細胞移植(Allo-he matopoietic Stem Cell Transplantation,allo-HSCT)術后CMV感染的有效性和安全性。方法:預防組從干細胞移植入倉時確認均無CMV感染(DNA量5.0×102拷貝/ml),即開始口服阿昔洛韋緩釋片,體重10~14kg者:0.2g/次,每天二次;體重15~25kg者:0.2g/次,每天三次;體重25kg者:0.4g/次,每天二次。每周連用三天停用四天。對照組為同一時期的干細胞移植患者,未使用任何抗病毒的藥物預防CMV感染。兩組患者均使用復方磺胺甲基異惡唑口服預防繼發(fā)細菌性感染,每周連用三天停用四天。以血清CMV病毒DNA量5.0×102/ml評定為CMV感染,比兩組的CMV感染率。安全性指標觀察包括:移植后血象指標血紅蛋白、WBC和血小板,干細胞植入嵌合率、肝功能、腎功能等。結果:預防組20例,隨訪12個月,除1例(5.0%)在出倉后14天(移植后45天)出現CMV感染(DNA量1.9×104/ml),一例出現血小板下降和血紅蛋白下降,需要停藥。未預防組出現感染22例(55.0%),其中15例(68.2%)的CMV感染發(fā)生在移植后90天以內,其中典型的巨細胞病毒肺炎2例。兩組的血液學指標Hb、WBC、NEU、Plt無顯著性差別,兩組的干細胞植入嵌合率無顯著性差別。2例出倉時已有CMV感染的患者使用阿昔洛韋緩釋片治療無效,需要改靜脈使用更昔洛韋。兩組的肝功能、腎功能參數無顯著性差別。結論:干細胞移植術后長期口服阿昔洛韋緩釋片預防CMV感染是有效和安全的。1)可明顯降低CMV感染率;2)對移植后的干細胞植入嵌合率無影響;3)對移植后的血液學指標無明顯影響;4)對肝腎功能無影響。
[Abstract]:Objective: to investigate the efficacy and safety of acyclovir sustained-release tablets in preventing CMV infection after Allo-he matopoietic Stem Cell Transplantationallo-HSCT (Allo-he matopoietic Stem Cell Transplantationallo-HSCT). Methods: in the prevention group, no CMV infection was confirmed at the time of stem cell transplantation (the amount of DNA was 5.0 脳 10 ~ 2 copies / ml), that is, acyclovir sustained release tablet was taken orally, weight 10~14kg was 0.2g / time twice a day, 15~25kg was 0.2g / time, three times a day, weight 25kg was 0.4g / time, twice a day. Use three days a week for four days. The control group was a stem cell transplant patient in the same period and did not use any anti-viral drugs to prevent CMV infection. Patients in both groups were treated with compound sulfamethoxazole orally to prevent secondary bacterial infection. CMV infection was assessed by serum CMV-DNA volume of 5.0 脳 102/ml, which was higher than that of the two groups. The safety indexes included hemoglobin WBC and platelet, chimerism rate of stem cell implantation, liver function, renal function and so on. Results: in the prevention group, 20 cases were followed up for 12 months, except 1 case (5.0%) developed CMV infection (104/ml volume 1.9 脳 104/ml) 14 days (45 days after transplantation), and one case had thrombocytopenia and hemoglobin decline. There were 22 cases (55.0%) with CMV infection in the untreated group, of which 15 cases (68.2%) had CMV infection within 90 days after transplantation, including 2 cases of typical cytomegalovirus pneumonia. There was no significant difference between the two groups in hematological index HbBCCnneuPlt. There was no significant difference in chimeric rate of stem cell implantation between the two groups. 2 cases of patients with CMV infection at the time of exit were not treated with acyclovir sustained-release tablets, so it was necessary to use ganciclovir intravenously. There was no significant difference in liver function and renal function between the two groups. Conclusion: Long-term oral administration of acyclovir sustained-release tablets after stem cell transplantation is effective and safe in preventing CMV infection. There was no significant effect on liver and kidney function.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R725.1;R457.7

【相似文獻】

相關期刊論文 前10條

1 李健;;自身干細胞移植挽救狼瘡病患者[J];生理科學進展;2006年02期

2 金世柱;韓明子;裴鳳華;;粒細胞集落刺激因子在干細胞移植中的應用進展[J];基礎醫(yī)學與臨床;2008年03期

3 劉立剛;魏翔;潘鐵成;李軍;潘友民;趙金平;;干細胞移植與冠狀動脈旁路移植術[J];中國老年學雜志;2008年12期

4 赫介;;干細胞移植[J];實用糖尿病雜志;2010年01期

5 島崎千尋,王錦麗,張芹;周圍血干細胞移植在急性髓細胞性白血病第一緩解期的治療[J];日本醫(yī)學介紹;1999年12期

6 朱_g ,時o踥，

本文編號：2056495