异基因骨髓移植的肺部合并症

目的：探讨异基因骨髓移植（ａｌｏＢＭＴ）后肺部合并症发生的危险因素、发病机制及有效防治方法。方法：总结１８５例ａｌｏＢＭＴ患者的肺部合并症资料。结果：８９例患者发生９３例次肺部合并症，病因多为感染，其中细菌性肺炎２７例次，间质性肺炎７例次，肺真菌病１６例次，肺结核４例次，阻塞性肺病２例次，肺水肿２例次，肺脓疡１例；由２种或２种以上病原所致的肺部合并症３４例次。由肺部疾患导致死亡者２３例（病死率１２．４％）。结论：ａｌｏＢＭＴ后肺部合并症的发生与受者年龄、性别、ＢＭＴ前骨髓状态、预处理方法及肺功能均无关；而移植物抗宿主病显著提高ＢＭＴ后患者肺部合并症的发病率及病死率。

Pulmonary complications occurring after allogeneic bone marrow transplantation]

OBJECTIVE: To explore the risk factors for and pathogenesis of pulmonary complications (PC) occurred after allogeneic bone marrow transplantation (allo-BMT). METHODS: The PC in 185 patients undergone allo-BMT were analyzed. RESULTS: Ninety-three PC episodes were observed in 89 patients and most of them were due to infections, including bacterial pneumonia (n = 27), interstitial pneumonia (n = 7), pulmonary fungus disease (n = 16), tuberculosis (n = 4), obstructive lung disease (n = 2), pulmonary edema (n = 2), lung abscess (n = 1) and 34 episodes caused by two or more pathogens. The overall mortality for PC was 12.43% (23/185). CONCLUSION: The risk factors for PC occurred after allo-BMT were not related to age and sex of recipients, bone marrow status before BMT, conditioning regimen and pulmonary function. Graft-versus-host-disease significantly increased the morbidity and mortality of PC after allo-BMT.