Simková P, Jindra P, Koza V, Cerná K
Hematologicko-onkologické oddĕlení FN, Plzen.
Vnitr Lek. 2002 Feb;48(2):120-4.
The objective of the work was to evaluate the frequency and time of incidence of cytomegaloviral (CMV) infection and disease in patients after allogeneic bone marrow transplantation (BMT). One hundred patients were followed up (70 with a related and 30 with an unrelated donor), who had transplantations during the period between XI/1996-XI/2000.
nested-PCR (MIE-gene) and antigenaemia (antigen pp65). Active CMV infection was proved in antigenaemia > or = 5 positive cells or in two consecutive positive PCR. The CMV syndrome was assessed in confirmed CMV infection and otherwise inexplicable febrile conditions and/or a drop of haemogram values. For the diagnosis of CMV pneumonia the clinical picture was needed, evidence of active CMV infection and on the X-ray of the lungs interstitial pneumonia. In 33 patients both methods were used, in 67 only PCR. The first positive test appeared 6-321 days after BMT (median +/- 49 days). CMV infection was proved in 44% cases, CMV syndrome in 30% and CMV pneumonia in 4%. In patients with a related donor CMV infection was found in 34.3%, CMV syndrome in 22.9%, CMV pneumonia in 1.4%. After unrelated donor BMT CMV infection was recorded in 66.7%, CMV syndrome in 46.7% and CMV pneumonia in 10% patients. Two patients died from CMV pneumonia. CMV pneumonia was diagnosed 57-115 days after BMT (median +/- 68 days. The risk of CMV infection is high in both groups of patients, in particular in patients after unrelated donor BMT (66.7%). As far as the development of CMV pneumonia was concerned, the mortality in the authors' group was 50%.
本研究的目的是评估异基因骨髓移植（BMT）患者中巨细胞病毒（CMV）感染及疾病的发生频率和时间。对1996年11月至2000年11月期间接受移植的100例患者进行了随访（70例有血缘关系供者，30例有无血缘关系供者）。
巢式PCR（MIE基因）和抗原血症（抗原pp65）。当抗原血症中≥5个阳性细胞或连续两次PCR阳性时，证明存在活动性CMV感染。在确诊CMV感染且伴有无法解释的发热状况和/或血细胞计数下降时评估CMV综合征。诊断CMV肺炎需要临床表现、活动性CMV感染的证据以及肺部X线显示间质性肺炎。33例患者同时使用了两种方法，67例仅使用了PCR。首次阳性检测出现在BMT后6至321天（中位数±49天）。44%的病例证实有CMV感染，30%有CMV综合征，4%有CMV肺炎。有血缘关系供者的患者中，34.3%发现有CMV感染，22.9%有CMV综合征，1.4%有CMV肺炎。无血缘关系供者BMT后，66.7%的患者记录有CMV感染，46.7%有CMV综合征，10%有CMV肺炎。两名患者死于CMV肺炎。CMV肺炎在BMT后57至115天被诊断（中位数±68天）。两组患者中CMV感染风险都很高，尤其是无血缘关系供者BMT后的患者（66.7%）。就CMV肺炎的发生而言，作者组的死亡率为50%。
