摘要
为探讨骨髓移植（ＢＭＴ）患者发生出血性膀胱炎（ＨＣ）的发病有关因素及其治疗措施。对２９例患者和６３例患者分别检测了腺病毒和巨细胞病毒。预处理方案采用包括全身照时方案和改良马利兰、环磷酰胺方案。ＨＣ预防措施包括水化及碱化尿液、静脉用前列腺素Ｅ＿１（ＰＧＥ＿１），部分患者加用巯乙磺酸钠。结果：发生ＨＣ１６例（２３．８％）；腺病毒阳性１３例中１２例发生ＨＣ，而阴性１６例中仅有４例发生ＨＣ（Ｐ＜０．０１），巨细胞病毒阳性患者２９例中１３例发生ＨＣ，阴性患者３４例中３例发生ＨＣ（Ｐ＜０．０５）；移植物抗宿主病（ＧＶＨＤ）３２例中发生ＨＣ１０例，而未发生ＧＶＨＤ的２９例中３例发生ＨＣ（Ｐ＜０．０５）；混合ＢＭＴ组ＨＣ发生率高于其它类型ＢＭＴ组。经多元回归分析，ＨＣ的发生与ＢＭＴ类型、腺病毒感染及ＧＶＨＤ的发生均呈明显相关性。多因素分析，ＨＣ的发生与白血病类型、预处理方案和巨细胞病毒感染无明显相关性。ＨＣ的治疗是在预防性治疗基础上加用病毒唑；重症采用Ｆｏｌｅｙ导管或膀胱造瘘连续冲洗。无一例死于严重ＨＣ。
The occurrence and etiology of hemorrhagic cystitis(HC) in 67 patients received bone marrow transplantation(BMT)were investigated.All patients received the preparative regimens of Bu/Cy(34 cases)or Cy/TBI(33 cases).Adenovirus and cytomegalovirus were detected in 29 and 63 patients,respectively.As HC prophylaxis,forced alkaline diuresis and PGE1,were used in all pativents.Once HC developed,PGE1 and rabavirin were added on the basis of prophylaxis.Continuous bladder irrigation with rabavirin were given in some severe cases.HC occurred in 16 cases(23.8%).Twelve of 13 patients developed HC in adenovirus positive group,while only 4/16 had HC in adenovirus negative group(P<0.01).The occurrence of HC in CMV positive and negative patients were 13/29 and 3/23,respectively(P<0.05);Among the 32 patients with GVHD,10 and HC(31.3A%),but in 29 patients with out GVHD only 3 had HC(10.3%,P<0.05).In a multivariate analysis,the type of BMT except allo-BMT,adenovirus positive and patients with GVHD were significantly associated with the occurrence of HC.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
1996年第10期532-534,共3页
Chinese Journal of Hematology
关键词
骨髓移植
出血性膀胱炎
膀胱炎
病因
治疗
Bone marrow transplantation Hemorrhagic cystitis Adenovirus Graft-ver-sus-host-disease
