异基因干细胞移植后间质性肺炎的预防和治疗

目的探讨异基因造血干细胞移植中巨细胞病毒（CMV）感染和间质性肺炎（IP）的预防和治疗。方法2002年9月至2005年9月对24例患者进行异基因造血干细胞移植，男14例，女10例，其中12例接受清髓性、12例接受非清髓性预处理方案移植。用膦甲酸钠联合阿昔洛韦预防CMV感染和IP，对已发生CMV感染或IP的患者，将阿昔洛韦改为更昔洛韦治疗。结果移植后有4例（16．7％）感染CMV，中位时间为移植后49d，经治疗后好转；有3例（12．5％）发生IP，其中2例CMV—DNA在正常范围，1例患者为巨细胞病毒间质性肺炎（CMV—IP）。经治疗后，3例IP1例死亡，2例好转。结论膦甲酸钠联合阿昔洛韦或更昔洛韦预防治疗IP效果良好。

The prevention and treatment of interstitial pneumonia after allogeneic stem cell transplantation

Objective To explore the condition of cytomegalovirus(CMV) infection and interstitial pneumonia(IP) after allogeneic stem cell transplantation,and the effect of their prevention and treatment.Methods From Sep 2002 to Sep 2005,24 patients were treated with allogeneic stem cell transplantation.Among them,14 patients were male,10 patients were female.The conditioning regimen was myeloablative in 12 patients and was nonmyeloablative in the other 12 patients.The combination of foscarnet and aciclovir was used to prevent cytomegalovirus infection and interstitial pneumonia.If the infection or interstitial pneumonia occurred,aciclovir was replaced by ganciclovir.Results Four patients(16.7%) were infected with CMV after transplantation,the median time of infection was 49 days.The CMV infection was cleared after the treatment by(ganciclovir.) Interstitial pneumonia was discovered in 3 patients(12.5%),CMV-DNA was normal in 2 of them,while the rest one was affected by CMV-IP.After treatment,one patient of the three died,while the other two recovered.(Conclusion) The combination of foscarnet and aciclovir or ganciclovir is effective in the prevention and treatment of interstitial pneumonia.