造血干细胞移植后带状疱疹发生率的分析

目的分析造血干细胞移植（HSCT）后带状疱疹（HZ）发生率及其对生存的影响。方法对2003年1月-2010年12月在广州军区广州总医院血液科接受HSCT的96例患者发生HZ的情况进行回顾性分析。结果7例患者发生了HZ，移植后1年的累计发生率为7．3％，中位发病时间为术后70（50-290）d，中位持续时间为15（7～180）d。不同的移植物抗宿主疾病（GVHD）严重程度、不同的GVHD治疗强度、是否进行规律的阿昔洛韦预防，HZ发生率存在差异。Kaplan-Meier生存分析显示HZ发生对移植后1年的生存率无影响（P=0．87）。结论Hz是HSCT后常见的并发症，严重的GVHD、多种免疫抑制剂联合使用及不进行有效地阿昔洛韦预防影响HZ的发生，移植后HZ的发生对患者移植后1年的生存率无影响。

The incidence of herpes zoster after hematopoietic stem cell transplantation

Objective To analyze the incidence of herpes zoster （HZ） after allogeneic hematopoietic stem cell transplantation （HSCT） and its effect on 1-year survival. Methods The medical records of 96 patients undergoing HSCT in Department of Hematology of Guangzhou General Hospital of Guangzhou Military Command during January 2003 and December 2010 were reviewed. Results HZ was identified in 7 of the 96 patients within 1 year after transplantation with a cumulative incidence of 7.3%. The median time to onset after HSCT was 70 （range 50-290） days and the median duration of HZ was 10 （range 7-180） days. The severity of graft versus host disease （GVHD）, intensified treatment of GVHD and regular prevention with acyclovir were associated with the incidence of HZ. Kaplan-Meier survival analysis indicated that HZ had no effect on the 1-year survival of patients （P = 0.87）. Conclusions Post-HSCT HZ is a common complication. Severe GVHD, intensified treatment of GVHD and no regular prevention with acyclovir are associated with higher incidence of HZ, but 1-year survival of the patients is not affected by HZ.