临床儿科杂志 ›› 2023, Vol. 41 ›› Issue (3): 175-180.doi: 10.12372/jcp.2022.22e1706
徐佳伟, 金润铭
收稿日期:2023-01-03
出版日期:2023-03-15
发布日期:2023-03-10
XU Jiawei, JIN Runming
Received:2023-01-03
Published:2023-03-15
Online:2023-03-10
摘要:
再生障碍性贫血(AA)是一种骨髓造血衰竭性疾病,主要表现为骨髓造血功能低下、全血细胞减少和贫血/出血/感染征候群。异基因造血干细胞移植是治疗重型AA的重要手段。移植相关并发症的发生及管理仍是临床一巨大挑战,其预防和治疗可直接影响移植的效果、患儿长期的生存及生活质量。文章对AA患儿造血干细胞移植过程中常见移植并发症的诊断、预防及治疗进展予以阐述,以期提高患儿移植成功率及生存率。
徐佳伟, 金润铭. 儿童再生障碍性贫血造血干细胞移植相关并发症[J]. 临床儿科杂志, 2023, 41(3): 175-180.
XU Jiawei, JIN Runming. Research progress in complications related to hematopoietic stem cell transplantation in children with aplastic anemia[J]. Journal of Clinical Pediatrics, 2023, 41(3): 175-180.
表1
移植相关血栓性微血管病诊断标准"
| 组织活检有微血栓证据或满足以下7项指标中的5项 |
|---|
| ①乳酸脱氢酶(LDH)超过正常值上限 |
| ②蛋白尿(随机尿蛋白超过正常值上限或随机尿蛋白/肌酐≥2mg/mg |
| ③高血压(年龄<18岁:血压高于同年龄、性别和身高的健康人群血压正常参考值的上限;年龄≥18岁:血压≥140/90mmHg) |
| ④新发的血小板减少(血小板计数<50×109/L或血小板计数较基线水平减少≥50% |
| ⑤新发的贫血(血红蛋白值低于正常参考值下限或输血需求增加) |
| ⑥微血管病变证据(外周血中存在破碎红细胞或组织标本病理学检查结果提示微血管病) |
| ⑦终末补体活化(血浆sC5b-9值高于健康人群正常值上限) |
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