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

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。

Relationship between T Lymphocyte Reconstitution and Invasive Fungal Infections in Allogeneic Hematopoietic Stem Cell Transplant Recipients

Objective We designed a retrospectively study that analysed the risk factors for invasive fungal infections(IFI),the characteristic of T 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.Methods 127 allo...