异基因外周血造血干细胞移植后巨细胞病毒间质性肺炎

目的：探讨异基因外周血造血干细胞移植(Allo-PBSCT)后间质性肺炎（IP）的病因，危险因素及防治方法。方法；将Allo-PBSCT患者分为更昔洛韦（GCV）预防组18例和对照组（未预防组）22例，比较两组巨细胞病毒南性肺炎（CMV－IP）的发生率。结果：对照组Allo-PBSCT患者中并发CMV－IP5例，预防组无1例发生CMV－IP。发生CMV－IP的高危因素为女性供者，合并移植物抗宿主病（GVHD）。4例治愈，1例治疗无效死亡。结论：Allo-PBSCT后CMV感染是IP的主要病因，IP的发生与GVHD严重程度及妇性供者密切相关，GCV能有效预防和治疗CMV－IP。

Cytomegaloviral Interstitial Pneumonitis Following Allogeneic Periphe-ral Blood Stem Cell Transplantation

Objective: To explore risk factors,prevention and treatment of cytomegaloviral interstitial pneumonitis (CMV IP) after allogeneic peripheral blood stem cell transplantation (allo PBSCT ).Methods: Forty patients who received allo PBSCT were allocated to gancyclovir (GCV) group ( n =18) and control group ( n =22).The incidence of CMV IP in patients given prophylactic gancyclovir was compared with that in control group.Results: Five patients in control group developed CMV IP ,while none of patients in GCV prophylaxis group developed CMV IP ( P < 0.05 ).Female donor and graft versus host disease (GVHD) were associated with a high risk of CMV IP.Four cases of CMV IP were successfully treated with GCV,but one case resistant to GCV died of CMV IP.Conclusion: CMV infection is a major cause of interstitial pneumonitis after allo PBSCT,which is associated strongly with the severity of GVHD and female donor.Gancyclovir may be effective in both prevention and treatment of CMV IP.