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本文引用的文献

1
Epidemiological characteristics of respiratory syncytial virus infection in pediatric patients before, during the COVID-19 pandemic and after easing of COVID-19 restrictive measures in China.中国新冠疫情期间及疫情防控措施放宽前后儿童呼吸道合胞病毒感染的流行病学特征
J Med Virol. 2024 Jan;96(1):e29374. doi: 10.1002/jmv.29374.
2
American Society of Transplantation and Cellular Therapy Series: #7 - Management of Respiratory Syncytial Virus Infections in Hematopoietic Cell Transplant Recipients.美国移植与细胞治疗学会系列:#7-造血干细胞移植受者呼吸道合胞病毒感染的管理。
Transplant Cell Ther. 2023 Dec;29(12):730-738. doi: 10.1016/j.jtct.2023.09.018. Epub 2023 Sep 30.
3
Respiratory syncytial virus in adults with comorbidities: an update on epidemiology, vaccines, and treatments.成人伴发疾病的呼吸道合胞病毒:流行病学、疫苗和治疗方法的最新进展。
Clin Microbiol Infect. 2023 Dec;29(12):1538-1550. doi: 10.1016/j.cmi.2023.08.028. Epub 2023 Sep 2.
4
Respiratory Syncytial Virus Infection: An Update.呼吸道合胞病毒感染:最新进展。
Indian J Pediatr. 2023 Dec;90(12):1245-1253. doi: 10.1007/s12098-023-04613-w. Epub 2023 Jun 16.
5
Different recovery patterns of CMV-specific and WT1-specific T cells in patients with acute myeloid leukemia undergoing allogeneic hematopoietic cell transplantation: Impact of CMV infection and leukemia relapse.异基因造血细胞移植后急性髓系白血病患者 CMV 特异性和 WT1 特异性 T 细胞的不同恢复模式:CMV 感染和白血病复发的影响。
Front Immunol. 2023 Feb 7;13:1027593. doi: 10.3389/fimmu.2022.1027593. eCollection 2022.
6
Decline of RSV-specific antibodies during the COVID-19 pandemic.新冠疫情期间呼吸道合胞病毒特异性抗体的下降。
Lancet Infect Dis. 2023 Jan;23(1):23-25. doi: 10.1016/S1473-3099(22)00763-0. Epub 2022 Dec 1.
7
Review of respiratory syncytial virus infection among older adults and transplant recipients.老年人和移植受者呼吸道合胞病毒感染的综述。
Ther Adv Infect Dis. 2022 Apr 18;9:20499361221091413. doi: 10.1177/20499361221091413. eCollection 2022 Jan-Dec.
8
Acute Respiratory Illnesses in Children in the SARS-CoV-2 Pandemic: Prospective Multicenter Study.儿童在 SARS-CoV-2 大流行期间的急性呼吸道疾病:前瞻性多中心研究。
Pediatrics. 2021 Aug;148(2). doi: 10.1542/peds.2021-051462. Epub 2021 May 13.
9
Respiratory syncytial virus in hematopoietic cell transplant recipients and patients with hematologic malignancies.造血细胞移植受者和血液系统恶性肿瘤患者中的呼吸道合胞病毒。
Haematologica. 2019 Jul;104(7):1322-1331. doi: 10.3324/haematol.2018.215152. Epub 2019 Jun 20.
10
Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient.造血系统恶性肿瘤患者与干细胞移植受者的呼吸道病毒感染
Infect Dis Clin North Am. 2019 Jun;33(2):523-544. doi: 10.1016/j.idc.2019.02.004. Epub 2019 Mar 30.

[造血干细胞移植后成年患者呼吸道合胞病毒感染的临床特征及死亡危险因素]

[Clinical characteristics and risk factors for death of respiratory syncytial virus infection in adult patients after hematopoietic stem cell transplantation].

作者信息

Li Y, Zhang F, Liu C, Zhao X S, Mo X D, Wang F R, Yan C H, Wang Z D, Kong J, Zhang Y Y, Zheng F M, Liu Y, Cao L Q, Deng D X, Huang X J, Zhang X H

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking-Tsinghua Center for Life Science, Research Unit of Key Technique for Diagnosis and Treatment of Hematologic Malignancies, Chinese Academic of Medical Sciences, Beijing 100044, China.

Department of Clinical Laboratory, Peking University People's Hospital, Beijing 100044, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2024 Oct 14;45(10):916-922. doi: 10.3760/cma.j.cn121090-20240424-00162.

DOI:10.3760/cma.j.cn121090-20240424-00162
PMID:39622755
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11579751/
Abstract

To summarize the clinical features associated with respiratory syncytial virus (RSV) infection in patients following the hematopoietic stem cell transplant (HSCT) and exploring the risk factors for death. Patients who had RSV infection after undergoing HSCT from October 2023 to January 2024 in the hematology department of Peking University People's Hospital were enrolled in the study. The clinical characteristics of the participating patients were summarized. The clinical characteristics of the surviving and the dying patients were compared, and the risk factors of death were analyzed by binary logistic regression. Among the 43 RSV-positive HSCT patients, 20 (46.5%) were hypoxemic, six (14.0%) were admitted to the ICU for further treatment, four (9.3%) required tracheal intubation assisted ventilation, and seven patients (16.3%) died. A comparison of the clinical features of the surviving patients and the deceased patients demonstrated that the deceased patients had a lower PLT when infected with RSV [74.5 (8.0-348.0) ×10(9)/L 15.0 (10.0-62.0) ×10(9)/L, =0.003], a higher incidence of simultaneous bacterial infections (85.7% 41.7%, =0.046), and a higher rate of hematological recurrence (71.4% 13.9%, =0.004). Hematological recurrence (=15.500, 95% 2.336-102.848, =0.005), influenza A viral infection (=14.000, 95% 1.064-184.182, =0.045), and low PLT at the time of RSV infection (=0.945, 95% 0.894-0.999, =0.048) were the factors associated with death following HSCT. Patients infected with RSV after undergoing HSCT have a poor prognosis, and active prevention and treatment of RSV in the autumn and winter requires urgent attention.

摘要

总结造血干细胞移植(HSCT)后患者呼吸道合胞病毒(RSV)感染的临床特征,并探讨死亡危险因素。纳入2023年10月至2024年1月在北京大学人民医院血液科接受HSCT后发生RSV感染的患者。总结参与患者的临床特征。比较存活患者和死亡患者的临床特征,并通过二元逻辑回归分析死亡危险因素。在43例RSV阳性的HSCT患者中,20例(46.5%)出现低氧血症,6例(14.0%)入住ICU进一步治疗,4例(9.3%)需要气管插管辅助通气,7例患者(16.3%)死亡。存活患者和死亡患者临床特征比较显示,死亡患者感染RSV时血小板计数较低[74.5(8.0 - 348.0)×10⁹/L对15.0(10.0 - 62.0)×10⁹/L,P = 0.003],同时合并细菌感染的发生率较高(85.7%对41.7%,P = 0.046),血液学复发率较高(71.4%对13.9%,P = 0.004)。血液学复发(P = 15.500,95%CI 2.336 - 102.848,P = 0.005)、甲型流感病毒感染(P = 14.000,95%CI 1.064 - 184.182,P = 0.045)以及RSV感染时血小板计数低(P = 0.945,95%CI 0.894 - 0.999,P = 0.048)是HSCT后死亡的相关因素。HSCT后感染RSV的患者预后较差,秋冬季积极预防和治疗RSV感染亟待关注。