van Kraaij M G, Dekker A W, Verdonck L F, van Loon A M, Vinjé J, Koopmans M P, Rozenberg-Arska M
Department of Haematology, University Medical Centre Utrecht, The Netherlands.
Bone Marrow Transplant. 2000 Aug;26(3):299-303. doi: 10.1038/sj.bmt.1702484.
The incidence and aetiology of acute diarrhoea in 60 adult allogeneic or autologous stem cell transplant (SCT) recipients was determined in a prospective study. Stool specimens were obtained prior to SCT and on days +20, +40, +60 and +100 post transplant. Microbiological evaluation was performed for pathogenic bacteria, fungi, parasites and viruses. Forty-seven patients were evaluable of whom 31 had a total of 48 acute diarrhoeal episodes. Diarrhoea occurred in 79% of allogeneic and 47% of autologous SCT recipients (P < 0.05). Intestinal infections were found in three of 48 (6%) diarrhoeal episodes. Clostridium difficile with positive toxin was cultured twice and one stool specimen was positive for cryptosporidium. Intestinal pathogens were identified in 13 out of 172 stool specimens from asymptomatic patients and included: rotavirus (4), adenovirus (3), C. difficile, toxin positive (2), and others (4). Graft-versus-host disease was confirmed by biopsy in two of 36 episodes of diarrhoea in allogeneic patients, and in three patients a relationship between reactivation of cytomegalovirus and diarrhoea was suspected. In 40 of 48 (83%) episodes of diarrhoea no clear aetiology could be found.
在一项前瞻性研究中，确定了60名接受同种异体或自体干细胞移植（SCT）的成年患者急性腹泻的发病率和病因。在SCT前以及移植后第20、40、60和100天采集粪便标本。对病原菌、真菌、寄生虫和病毒进行微生物学评估。47名患者可进行评估，其中31名患者共出现48次急性腹泻发作。腹泻发生在79%的同种异体SCT受者和47%的自体SCT受者中（P<0.05）。48次腹泻发作中有3次（6%）发现肠道感染。艰难梭菌毒素检测呈阳性的情况出现了两次，一份粪便标本隐孢子虫检测呈阳性。在无症状患者的172份粪便标本中，有13份鉴定出肠道病原体，包括：轮状病毒（4份）、腺病毒（3份）、艰难梭菌毒素阳性（2份）以及其他（4份）。在同种异体患者的36次腹泻发作中，经活检确诊有2次发生移植物抗宿主病，3名患者疑似巨细胞病毒再激活与腹泻有关。在48次腹泻发作中有40次（83%）未发现明确病因。
