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目的 :分析急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)异基因造血干细胞移植(allo-HSCT)患者移植早期急性心衰事件危险因素以及心衰患者的临床特点。方法:搜集ALL allo-HSCT患者67例,依据移植早期(移植后100 d内)患者有无发生急性心衰事件而分为心衰组(19例)和对照组(48例)。运用单因素分析、Pearsonχ2检验和t检验等统计学方法分析急性心衰事件的危险因素及心衰组的临床特点。结果:ALL allo-HSCT患者移植早期急性心衰事件发生中位时间为移植后4 d(移植前1 d~移植后78 d)。单因素分析显示,Ph+ALL移植前酪氨酸激酶抑制剂(TKI)治疗史为急性心衰事件的危险因素;心衰组细菌感染及死亡等不良预后事件发生率都较对照组高(P<0.05)。结论:ALL allo-HSCT患者急性心衰事件多发生在移植早期,Ph+ALL移植前TKI治疗史是ALL患者移植早期急性心衰事件的危险因素,心衰组患者常伴随较高的细菌感染及不良预后事件发生率。
OBJECTIVE: To analyze the risk factors of early acute heart failure and the clinical features of patients with heart failure after allo-HSCT in patients with acute lymphoblastic leukemia (ALL). Methods: A total of 67 patients with ALL allo-HSCT were enrolled in this study. They were divided into heart failure group (n = 19) and control group (n = 48) according to the presence or absence of acute heart failure in the early stage of transplantation (within 100 days after transplantation). Using univariate analysis, Pearsonχ2 test and t test and other statistical methods to analyze the risk factors of acute heart failure and clinical features of heart failure group. Results: The median time to acute early heart failure in ALL allo-HSCT patients was 4 days after transplantation (1 day before transplantation ~ 78 days after transplantation). Univariate analysis showed that the treatment of Ph + ALL pretransplant tyrosine kinase inhibitor (TKI) was a risk factor for acute heart failure. The incidences of adverse events such as bacterial infection and death in HF group were higher than those in control group (P <0.05). CONCLUSION: Acute heart failure in patients with ALL allo-HSCT occurs mostly in the early stage of transplantation. The history of TKI before transplantation of Ph + ALL is a risk factor for early acute heart failure in ALL patients. Patients with heart failure often have higher bacterial infection and Adverse event rate.