RISK-FACTORS FOR AIR-FLOW OBSTRUCTION IN RECIPIENTS OF BONE-MARROW TRANSPLANTS
RISK-FACTORS FOR AIR-FLOW OBSTRUCTION IN RECIPIENTS OF BONE-MARROW TRANSPLANTS
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DOI：
10.7326/0003-4819-107-5-648
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发表时间：
1987-11-01
影响因子：
39.2
通讯作者：
THOMAS, ED
中科院分区：
文献类型：
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作者：
CLARK, JG;SCHWARTZ, DA;THOMAS, ED
阻塞性肺病是骨髓移植的并发症。为了确定危险因素，我们分析了281例成人患者骨髓移植后1年的肺功能检查。使用1秒用力呼气量除以用力肺活量（FEV 1/FVC）来测量气流速率。与较低的第1年FEV 1/FVC（%）相关的因素包括年龄增加（p < 0.0001），男性（p = 0.02），吸烟（p = 0.01），移植前FEV 1/FVC较低（p < 0.0001）、HLA不一致移植物（p = 0.001）、慢性移植物抗宿主病（p = 0.0002）和甲氨蝶呤免疫抑制治疗（p = 0.01）。第1年FEV 1/FVC与基础疾病、预处理照射剂量或急性移植物抗宿主病的发生之间无显著相关性。在对移植前FEV 1/FVC进行控制后，线性多变量回归分析显示慢性移植物抗宿主病和甲氨蝶呤给药均与第1年FEV 1/FVC下降独立相关。慢性移植物抗宿主病和甲氨蝶呤的联合发生也与第1年FEV 1/FVC的降低密切相关，表明这些风险因素之间存在相互作用。
Obstructive lung disease is a complication of bone marrow transplantation. To identify risk factors we analyzed pulmonary function tests of 281 adult patients 1 year after marrow transplantation. The forced expiratory volume at 1 second divided by the forced vital capacity (FEV1/FVC) was used to measure airflow rates. Factors associated with a lower year-1 FEV1/FVC (%) included increased age (p < 0.0001), male gender (p = 0.02), cigarette smoking (p = 0.01), lower FEV1/FVC before transplantation (p < 0.0001), HLA-nonidentical grafts (p = 0.001), chronic graft-versus-host disease (p = 0.0002), and immunosuppressive therapy with methotrexate (p = 0.01). There was no significant association between the year-1 FEV1/FVC and underlying disease, dose of conditioning irradiation, or development of acute graft-versus-host disease. Linear multivariate regression analysis, after controlling for the FEV1/FVC before transplantation, shows both chronic graft-versus-host disease and administration of methotrexate independently associated with decrements in the year-1 FEV1/FVC. The combined occurrence of chronic graft-versus host disease and methotrexate also was strongly associated with decreases in the year-1 FEV1/FVC, indicating an interaction of these risk factors.