儿童造血干细胞移植后泌尿系统常见并发症及机制

造血干细胞移植(hematopoietic stem cell transplantation,HSCT)是多种血液系统疾病的重要治疗手段,而泌尿系损伤是HSCT常见并发症之一,包括急性肾损伤、慢性肾脏病、移植后肾病综合征、移植相关性血栓性微血管病、泌尿道感染、出血性膀胱炎等.按照其发生原因分为肾前性、肾性及肾后性三个方面,不同因素相互影响.其临床表现、治疗及预后因疾病类型及严重程度的不同而有差异.肾活检对于病因分析、指导治疗和判断预后有重要意义.该文就儿童HSCT泌尿系统常见并发症及其机制作一综述.

Common complications and mechanisms of urinary system after hematopoietic stem cell transplantation in children

Hematopoietic stem cell transplantation(HSCT)is an important treatment of various hematological diseases,and urinary system injury is one of the common complications after HSCT,including acute renal damage,chronic kidney disease,nephrotic syndrome after transplantation,transplantation associated thrombotic microangiopathy,urinary tract infection,hemorrhagic cystitis,etc.The etiology includes three aspects:prerenal,renal and postrenal.Various factors have interactions with each other.The clinical manifestations,treatment and prognosis are different due to the disease types and severity.Renal biopsy is of great significance for the etiological analysis,therapeutic guide and prognostic vaule.This article reviews the common complications and mechanisms of urinary system after HSCT in children.