Cahill R A, Spitzer T R, Mazumder A
Naval Medical Research Institute, National Naval Medical Center, Bethesda, MD, USA.
Bone Marrow Transplant. 1996 Jul;18(1):177-84.
A capillary leak syndrome occurs frequently in bone marrow transplant patients in addition to graft-versus-host-disease and infection. The underlying pathology is poorly understood but the clinical manifestations of excessive weight gain, ascites, and edema associated with kidney and liver abnormalities suggest a common injury to multiple organs. The clinical courses of 55 allogeneic and autologous marrow transplant recipients were retrospectively reviewed with regard to the presentation of a capillary leak syndrome (CLS). Twenty-nine patients (53%) developed non-cardiogenic pulmonary edema with or without concurrent pleural effusions; the incidence was comparable in allogeneic and autologous recipients. Pulmonary features were accompanied by hepatic dysfunction in 28, renal dysfunction in 22, and central nervous system abnormalities in 17. There was a strong correlation between time of engraftment and the first manifestations of CLS, both of which occurred earlier in allogeneic than in autologous transplant recipients. These data confirm that CLS occurs in both allogeneic and autologous transplant recipients and suggest a pivotal contribution by circulating leukocytes.
除移植物抗宿主病和感染外，毛细血管渗漏综合征在骨髓移植患者中也经常发生。其潜在病理机制尚不清楚，但体重过度增加、腹水以及与肝肾异常相关的水肿等临床表现提示多器官存在共同损伤。回顾性分析了55例异基因和自体骨髓移植受者发生毛细血管渗漏综合征（CLS）的临床过程。29例患者（53%）出现了非心源性肺水肿，伴或不伴有胸腔积液；异基因和自体移植受者的发病率相当。28例患者的肺部表现伴有肝功能障碍，22例伴有肾功能障碍，17例伴有中枢神经系统异常。植入时间与CLS的首发表现之间存在很强的相关性，两者在异基因移植受者中均比自体移植受者出现得更早。这些数据证实CLS在异基因和自体移植受者中均会发生，并提示循环白细胞起关键作用。
