Objective: To explore risk factors, clinical characteristics and prognosis of CMV enteritis combined with severe intestinal graft- versus- host disease (GVHD).
Methods: The data of 80 intestinal grade Ⅲ/Ⅳ GVHD patients from January 2005 to September 2015 in hematology of PKUPH were retrospectively analyzed. All patients received colonoscopy and all GVHD diagnoses were based on clinical manifestation, colonoscopy and biopsies. All patients were divided into biopsy- proven CMV enteritis and control groups. Various characteristics, clinical manifestation and transplantation related mortality were compared.
Results: A total of 18 patients were diagnosed with biopsy- proven CMV enteritis, including 14 antigens positive, 2 inclusion bodies positive (1 positive for both antigen and inclusion body) and 3 intestinal mucosa CMV PCR positive. The median diagnosis time for CMV enteritis was 65 days (range, 27 to 278 days) after transplantation. There was no statistically difference for baseline (age, gender, underlying disease, status of disease, et al) between two groups. The NRM between CMV enteritis and control groups was significantly different (61.1% vs. 33.9%,P=0.044).
Conclusion: CMV enteritis was a risk factor of NRM for grade Ⅲ/Ⅳ intestinal GVHD.
目的: 探讨重度肠道移植物抗宿主病（GVHD）合并巨细胞病毒（CMV）肠炎的危险因素、临床特点及预后。
方法: 回顾性分析2005年1月1日至2015年9月1日期间确诊的80例Ⅲ/Ⅳ级肠道GVHD患者的临床资料，依据有无CMV肠炎（病理诊断）分为CMV肠炎组（18例）和对照组（62例），比较两组患者的基线特征、临床特点及非复发死亡率。
结果: CMV肠炎组18例患者中，CMV抗原阳性14例，肠黏膜匀浆CMV核酸阳性3例，CMV包涵体阳性2例（其中1例为CMV抗原阳性＋包涵体阳性）。确诊CMV肠炎的中位时间为移植后65(27~278) d。两组基线水平（年龄、性别、原发病、疾病状态等）差异无统计学意义。中位随访15.0(0.5~110.5）个月，CMV肠炎组移植后非复发死亡率高于对照组（61.1％对33.9%，P=0.044）。
结论: 合并CMV肠炎是Ⅲ/Ⅳ级肠道GVHD患者移植后非复发死亡的危险因素。