肝移植术后发生人细小病毒B19相关纯红细胞再生障碍性贫血的临床特点分析

张达利; 臧红; 高银杰; 郭桐生; 周霞; 贺希; 刘鸿凌

doi:10.3969/j.issn.1001-5256.2017.01.032

肝移植术后发生人细小病毒B19相关纯红细胞再生障碍性贫血的临床特点分析

DOI: 10.3969/j.issn.1001-5256.2017.01.032

1. 解放军第三〇二医院肝移植研究中心
2. 解放军第三〇二医院临床检验医学中心

基金项目:

首都市民健康培育(Z161100000116058)；三○二医院基金项目(YNKT2014006)；

详细信息

中图分类号: R556.5;R657.3
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出版历程
- 出版日期: 2017-01-20

Clinical features of pure red cell aplasia associated with human parvovirus B19 infection after liver transplantation

Liver Transplantation Research Center, 302 Hospital of PLA, Beijing 100039, China

Research funding:

摘要

摘要:
目的观察肝移植术后发生人细小病毒B19（HPV B19）相关纯红细胞再生障碍性贫血（PRCA）患者的临床特点。方法收集2007年7月-2016年7月于解放军第三〇二医院行肝移植术后定期随访的患者420例,其中5例患者短期内Hb水平进行性下降,骨髓细胞学检查提示红系造血障碍,HPV B19 Ig M阳性,排除其他病因后诊断为PRCA。予人丙种球蛋白、糖皮质激素、调整免疫抑制剂等治疗。观察治疗过程中患者的临床表现,外周血细胞分析中网织红细胞计数（RC）、Hb、WBC、PLT、骨髓象改变,以及肝功能、肾功能等相关指标变化。结果给予人丙种球蛋白、糖皮质激素、输注RBC等综合治疗后,5例患者乏力、气短、头晕等症状明显减轻,外周血细胞分析中Hb、RC水平明显恢复,贫血得到纠正。结论对于HPV B19相关PRCA患者,早期诊断并及时给予人丙种球蛋白、糖皮质激素等治疗可取得较好的疗效。
- 肝移植 /
- 细小病毒B19,人 /
- 贫血
Abstract:
Objective To investigate the clinical features of patients with pure red cell aplasia( PRCA) associated with human parvovirus B19( HPV B19) infection after liver transplantation. Methods The clinical data of 420 patients who underwent liver transplantation in 302 Hospital of PLA from July 2007 to July 2016 and were followed up regularly were collected,and among these patients,five had a progressive reduction in hemoglobin( Hb) level within a short period of time. Bone marrow cytological examination showed erythropoiesis disorders and positive HPV B19 Ig M,and the patients were diagnosed with PRCA after the exclusion of other causes. The patients were given human gamma- globulin,glucocorticoids,and adjustment of immunosuppressants. The patients' clinical manifestations during treatment and the changes in reticulocyte count( RC),Hb,white blood cell count( WBC),platelet count( PLT),and myelogram findings determined by peripheral blood cell analysis were observed,as well as the changes in liver and renal function parameters. Results After the multimodality therapy using human gamma- globulin,glucocorticoids,and red blood cell infusion,the five patients had significant alleviation in the symptoms of weakness,short breath,and dizziness,and the peripheral blood cell analysis showed recovery of Hb and RC,suggesting that anemia was corrected. Conclusion As for patients with PRCA associated with HPV B19 infection,early diagnosis and treatment with human gamma-globulin and glucocorticoids can achieve a good therapeutic effect.
- liver transplantation /
- parvovirus B19 /
- human

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