造血干细胞移植后发生出血性膀胱炎危险因素的分析

目的探讨造血干细胞移植术（HSCT）后出血性膀胱炎的发病相关因素、治疗措施和预后。方法分析我科2000年3月～2008年2月126例HSCT患者出血性膀胱炎发病情况。结果126例移植受者中17例发生出血性膀胱炎,发生率13．5％,中位发病时间36天（16～150天）,中位病程25天（10～103天）,所有患者经过再次水化、利尿和（或）留置导尿管持续膀胱冲洗等治疗,均获得治愈。结论在充分预防出血性膀胱炎后,出血性膀胱炎多为迟发型。多因素分析显示,移植方式、HLA相合程度、急性移植物抗宿主病、异基因移植、清髓性预处理和CMV感染是引起出血性膀胱炎的危险因素。

Risk factors about hemorrhagic cystitis after hemopoietic stem cell transplantation

Objective Severe hemorrhagic cystitis-（HC） may be a life-threatening complication in hemopoietic stem cell transplantation （HSCT）. In order to get the correlation factors and improve the strategies for prophylaxis and treatment. Methods We retrospectively analyzed data on 126 patients who underwent HSCT at our center from 2000 through 2008. Results Of 126 patients, 17 （ 17/126 13.5% ） developed HC. HC started on a median of 36 （16-150） days post-transplant and persisted for a median of 25 （10-103） days. All the patients were cured by treating with alkalinization of the urine and hyperhydration with intravenous glucose solution and electrolytes and urethral catheterization to bladder washout. Conclusion The 17 patients got late onset hemorrhagic cystitis. In multivariate analysis, the risk factors for HC were transplant way, HLA match, acute graft-versus-host disease （aGVHD） , allo-HSCT, myeloablative regiment and cytomegalovirus infection.