Schulenburg A, Turetschek K, Wrba F, Vogelsang H, Greinix H T, Keil F, Mitterbauer M, Kalhs P
Bone Marrow Transplantation, Department of Medicine I, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Ann Hematol. 2004 Feb;83(2):101-6. doi: 10.1007/s00277-003-0756-4. Epub 2003 Nov 13.
Upper and lower gastrointestinal symptoms are major and serious complications after stem cell transplantation. Their main causes are gastrointestinal graft-versus-host disease (GVHD), infections, toxicity, or preexisting gastrointestinal diseases. The clinical presentation of each disease is nonspecific. The diagnostic procedure for this study included physical exam, stool cultures, endoscopy with biopsies, and abdominal computed tomography (CT). The study was designed prospectively with consecutive patients and performed at our institution in a clinical stem cell transplantation setting. Between January 1996 and September 2001, we analyzed 42 consecutive patients who had been admitted at our institution for gastrointestinal complaints after allogeneic stem cell transplantation for hematologic diseases. Diagnostic procedures revealed in decreasing order: GVHD (62%), gastritis/esophagitis (19%), cytomegalovirus (CMV) enteritis (11%), bacterial enteritis (6%), and toxic mucosal damage (2%). CT showed unspecific findings. Gastrointestinal GVHD and infectious colitis accounted for the majority of gastrointestinal complications after allogeneic stem cell transplantation in our patient population. The diagnosis was mainly based on endoscopically obtained biopsies.
上、下消化道症状是干细胞移植后主要且严重的并发症。其主要病因是胃肠道移植物抗宿主病（GVHD）、感染、毒性作用或既往存在的胃肠道疾病。每种疾病的临床表现均不具有特异性。本研究的诊断程序包括体格检查、粪便培养、内镜检查及活检以及腹部计算机断层扫描（CT）。本研究对连续患者进行前瞻性设计，并在我们机构的临床干细胞移植环境中开展。在1996年1月至2001年9月期间，我们分析了42例因血液系统疾病接受异基因干细胞移植后因胃肠道不适入住我们机构的连续患者。诊断程序显示结果由高到低依次为：GVHD（62%）、胃炎/食管炎（19%）、巨细胞病毒（CMV）肠炎（11%）、细菌性肠炎（6%）和毒性黏膜损伤（2%）。CT显示非特异性结果。在我们的患者群体中，胃肠道GVHD和感染性结肠炎占异基因干细胞移植后胃肠道并发症的大部分。诊断主要基于内镜获取的活检结果。
