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目的:探讨预防治疗及预先治疗对异基因造血干细胞移植后CMV感染的干预作用。方法:225例异基因造血干细胞移植患者中160例接受预先治疗,65例接受预防治疗,用logistic回归模型分析影响CMV感染的危险因素。结果:预先治疗组与预防治疗组比较,CMVpp65抗原血症、CMV病和CMV病死亡率分别为28.1%(35.3%,P>0.05)、1.9%(12.3%,P<0.05)和0.6%(10.7%,P<0.01)。单倍体相合移植组出现CM-Vpp65血症33.0%(40.0%,P>0.05)、CMV病发生率1.9%(12.0%,P<0.05)、死亡率0.0%(10.0%,P<0.05),均低于相合移植。单倍体相合移植组中CMVpp65阳性发生的主要危险因素为重症GVHD、移植前给予抗CMV治疗以及是否混合其他严重感染。结论:异基因移植后预先治疗优于预防治疗,可以明显减低CMV病的发生和死亡。
Objective: To investigate the effects of prophylactic treatment and pretreatment on CMV infection after allogeneic hematopoietic stem cell transplantation. Methods: One hundred and twenty-five patients with allogeneic hematopoietic stem cell transplantation received pretreatment and 65 received prophylaxis. The risk factors affecting CMV infection were analyzed by logistic regression model. RESULTS: The mortality rates of CMVpp65 antigens, CMV and CMV were 28.1% (35.3%, P> 0.05), 1.9% (12.3%, P <0.05) and 0.6% (P <0.05) respectively in the pretreatment group and the prophylaxis group 10.7%, P <0.01). The incidence of CMV was 1.9% (12.0%, P <0.05), and the mortality rate was 0.0% (10.0%, P <0.05) in haploidentical transplantation group. , Were lower than matched transplantation. The major risk factors for CMVpp65 positive in the haploidentical co-transplantation group were severe GVHD, anti-CMV treatment before transplantation and other serious infections. Conclusion: Allogeneic transplantation is better than prophylaxis before treatment, which can significantly reduce the occurrence and death of CMV.