临床眼科杂志2025，Vol.33Issue(5)：401-406,6.DOI:10.3969/j.issn.1006-8422.2025.05.004
异基因造血干细胞移植术后并发巨细胞病毒视网膜炎患者房水病毒载量变化危险因素分析
Analysis of risk factors for changes in viral load in aqueous humor in patients with cytomegalovirus retinitis following allogeneic hematopoietic stem cell transplantation
摘要
Abstract
Objective To observe the changes in viral load in the atrial fluid of patients with cytomegalovirus reti-nitis(CMVR)complicating after allogeneic hematopoietic stem cell transplantation(Allo-HSCT)and to analyze its risk factors.Methods A retrospective case series study.Using the consecutive sampling convenience method,30 patients with 42 eyes admitted to the department of ophthalmology of Southeast Hospital from January 2017 to December 2022 with CMVR complicated after Allo-HSCT were selected for inclusion in the study.The median age was 29 years old,there were 18 and 12 cases of monocular and binocular eyes,respectively.Among them,there were 14 cases of 18 eyes and 16 cases of 24 eyes in males and females,respectively.Patients were treated with intraocular injections of 0.05 mL ganciclovir(30 mg/ml).This was given twice a week for 2 weeks during the induction period and once a week during the maintenance pe-riod.The CMV deoxyribonucleic acid(CMV-DNA)load detected in the atrial fluid before each weekly ganciclovir injec-tion was recorded.Treatment was discontinued if the CMV-DNA load in atrial fluid became negative,and follow-up was continued for no less than six months.Real-time quantitative polymerase chain reaction(PCR)was performed to monitor the CMV-DNA load in the atrial fluid,and the eyes were categorized into a non-sustained decline group(with a transient increase)and a sustained decline group(with a continuous decline)according to whether the CMV-DNA load in the atrial fluid of the patient's eyes increased transient during the course of treatment.The changes in the aqueous CMV-DNA loads in the affected eyes of the two groups were compared,as well as the differences between the eyes,which were further ana-lyzed using multifactorial analysis.Results The median number of ganciclovir injections in the affected eyes at the end of treatment was 7(4,10).42 eyes,the persistent group contained 19 eyes(45.24%)and the non-persistent group contained 23 eyes(54.76%).Initial atrial fluid IL-8 levels(high)and baseline CD4+T-lymphocyte counts(≤50)were independent risk factors influencing the one-pass elevation of CMV-DNA load changes in patients with concomitant CMVR after Allo-HSCT in both groups of affected eyes.Conclusions The higher the IL-8 level of the affected eye's atrial fluid and the lower the baseline CD4+T lymphocyte count at the beginning of the treatment period in patients with cytomegalovirus retini-tis after Allo-HSCT,the greater the risk for patients to develop a transient elevation of CMV-DNA load during the treatment period.关键词
异基因造血干细胞移植术/巨细胞病毒视网膜炎/房水病毒载量变化/危险因素Key words
Allogeneic hematopoietic stem cell transplantation/Cytomegalovirus retinitis/Atrial fluid viral load change/Risk factors引用本文复制引用
黄俊琴,陈德权,方颉..异基因造血干细胞移植术后并发巨细胞病毒视网膜炎患者房水病毒载量变化危险因素分析[J].临床眼科杂志,2025,33(5):401-406,6.基金项目
厦门市科技局课题(3502Z20214ZD1209) （3502Z20214ZD1209）
