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[聚合酶链反应检测异基因造血干细胞移植后严重腹泻患者胃活检中人类疱疹病毒6型对腹泻病程的意义]

[Significance of PCR detection of HHV6 in gastro biopsy on the course of diarrhea in patients with severe diarrhea after allogeneic hematopoietic stem cell transplantation].

作者信息

Han T T, Zhao X S, Huang X J, Zhang X H, Liu K Y, Wang Y, Yan C H, Xu L P

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing 100044, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2017 Aug 14;38(8):690-694. doi: 10.3760/cma.j.issn.0253-2727.2017.08.008.

DOI:10.3760/cma.j.issn.0253-2727.2017.08.008
PMID:28954348
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7348244/
Abstract

To investigate the clinical significance of PCR detection of human herpesvirus 6 (HHV6) in gastro biopsy on the course of diarrhea in patients with severe diarrhea after allogeneic hematopoietic stem cell transplantation (HSCT) . Data from a cohort of 45 HSCT recipients (including age, sex, transplantation conditions, graft-versus-host disease, treatments, clinical signs, outcome, HHV6, and other infections) performed between 2015 and 2016 were collected. Univariate analysis was used to evaluate influences between the different parameters. Of the 45 enrolled recipients, 21 patients (46.7%) presented HHV6 positive in gastro-biopsy during the analyzed period. The incidence of CMV viremia in the positive HHV6 group was comparable with that in the negative HHV6 group. But the incidence of EBV viremia in the positive HHV6 group was significantly higher than in the negative HHV6 group (=0.028) . 44 out of 45 patients with severe diarrhea were given antiviral treatment with foscarnet and/or ganciclovir, the latter didn't influence the course of the diarrhea. Positive PCR results in GI tract samples didn't necessarily reflect reactivation of HHV6. Further studies are needed to define the significance of HHV6 for GI tract symptoms after allo-HSCT.

摘要

探讨在异基因造血干细胞移植(HSCT)后严重腹泻患者的胃活检中,通过聚合酶链反应(PCR)检测人疱疹病毒6型(HHV6)对腹泻病程的临床意义。收集了2015年至2016年间45例HSCT受者的队列数据(包括年龄、性别、移植条件、移植物抗宿主病、治疗方法、临床症状、结局、HHV6及其他感染情况)。采用单因素分析评估不同参数之间的影响。在45例登记的受者中,21例患者(46.7%)在分析期间胃活检中HHV6呈阳性。HHV6阳性组的巨细胞病毒血症发生率与HHV6阴性组相当。但HHV6阳性组的EB病毒血症发生率显著高于HHV6阴性组(P=0.028)。45例严重腹泻患者中有44例接受了膦甲酸钠和/或更昔洛韦抗病毒治疗,后者并未影响腹泻病程。胃肠道样本中PCR阳性结果不一定反映HHV6的再激活。需要进一步研究来确定HHV6对异基因造血干细胞移植后胃肠道症状的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e7/7348244/02b34aff4b11/cjh-38-08-690-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e7/7348244/02b34aff4b11/cjh-38-08-690-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e7/7348244/02b34aff4b11/cjh-38-08-690-g001.jpg

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本文引用的文献

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Isr Med Assoc J. 2015 May;17(5):302-5.
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[Prevalence of EBV infection in patients with allogeneic hematopoietic stem cell transplantation].[异基因造血干细胞移植患者中EB病毒感染的患病率]
Zhonghua Xue Ye Xue Za Zhi. 2013 Aug;34(8):651-4. doi: 10.3760/cma.j.issn.0253-2727.2013.08.002.
3
Human herpesvirus 6 infection after allogeneic stem cell transplantation: incidence, outcome, and factors associated with HHV-6 reactivation.
异基因造血干细胞移植后人类疱疹病毒 6 感染:发生率、结局及与 HHV-6 再激活相关的因素。
Transplantation. 2013 May 27;95(10):1292-8. doi: 10.1097/TP.0b013e318289958b.
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Gastrointestinal and hepatic complications of hematopoietic stem cell transplantation.造血干细胞移植的胃肠道和肝脏并发症。
World J Gastroenterol. 2012 Apr 28;18(16):1851-60. doi: 10.3748/wjg.v18.i16.1851.
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