Chen P M, Liu J H, Fan F S, Hsieh R K, Wei C H, Liu R S, Tzeng C H
Department of Internal Medicine, Veterans General Hospital-Taipei, Taiwan, Republic of China.
Transplantation. 1995 Apr 27;59(8):1139-43.
To investigate the causes of impaired liver function (LF)* after BMT, 88 patients were included for analysis of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, transplant methods, preconditioning regimens, and graft-versus-host disease (GVHD). Fifty of them (56.8%) developed abnormal LF after BMT and among them, 29 (32.9%) developed chronic hepatitis (CH). By univariate analysis, HCV infection, pretransplant abnormal LF, allogeneic BMT, and preconditioning regimen with total body irradiation were all significantly related to higher incidence of post-BMT impaired LF. However, only HCV infection, pretransplant abnormal LF, and acute GVHD were associated with higher incidence of CH. By multivariate logistic regression analysis, HCV infection and pretransplant abnormal LF were the two most significant interpreters for abnormal LF, especially for CH (odds ratios: 7.86 and 4.735, respectively) after BMT. Although the incidence of abnormal LF was found high in this study, there was no significant disadvantage in terms of survival for patients who developed abnormal acute and chronic liver function after BMT. However, a long-term follow-up is needed to evaluate survival pathology of CH, such as liver cirrhosis and hepatoma.
为了研究骨髓移植（BMT）后肝功能受损（LF）的原因，纳入了88例患者，分析其乙肝病毒（HBV）和丙肝病毒（HCV）感染情况、移植方法、预处理方案以及移植物抗宿主病（GVHD）。其中50例（56.8%）在BMT后出现肝功能异常，其中29例（32.9%）发展为慢性肝炎（CH）。单因素分析显示，HCV感染、移植前肝功能异常、异基因BMT以及全身照射预处理方案均与BMT后肝功能受损的较高发生率显著相关。然而，只有HCV感染、移植前肝功能异常和急性GVHD与CH的较高发生率相关。多因素逻辑回归分析显示，HCV感染和移植前肝功能异常是BMT后肝功能异常尤其是CH的两个最显著的解释因素（优势比分别为7.86和4.735）。尽管本研究中肝功能异常的发生率较高，但BMT后出现急性和慢性肝功能异常的患者在生存方面并无显著劣势。然而，需要长期随访来评估CH的生存病理情况，如肝硬化和肝癌。
