【摘要】 目的 分析異基因造血干細(xì)胞移植術(shù)（allogeneic hematopoietic stem cell transplantation，allo-HSCT）后出血性膀胱炎（hemorrhagic cystitis，HC）相關(guān)的危險(xiǎn)因素，動(dòng)態(tài)監(jiān)測(cè)受者尿BK病毒（BK virus，BKV），分析其與HC發(fā)病的關(guān)系?！》椒ā』仡櫺苑治?003年3月-2008年1月期間接受allo-HSCT的121例患者的資料，選擇8個(gè)臨床參數(shù)[年齡、性別、疾病類型、移植時(shí)疾病狀態(tài)、供者類型、預(yù)處理方案、急性移植物抗宿主病（acute graft-versus-host disease，aGVHD）、aGVHD的預(yù)防方案]作COX回歸分析。采用SYBR Green染料實(shí)時(shí)熒光定量聚合酶鏈反應(yīng)法對(duì)2006年9月-2008年1月42例allo-HSCT患者尿BKV載量進(jìn)行動(dòng)態(tài)監(jiān)測(cè)，分析被檢查者尿液BKV基因載量與HC發(fā)生以及嚴(yán)重程度的關(guān)系。 結(jié)果 121例患者中有24例發(fā)生HC，發(fā)病時(shí)間為術(shù)后0~63 d，中位時(shí)間40 d；持續(xù)時(shí)間7~150 d，中位時(shí)間22 d。Ⅱ~Ⅳ度aGVHD為HC的獨(dú)立危險(xiǎn)因素[RR=8.304，95%CI（1.223，56.396），P=0.030]。allo-HSCT受者尿液中BKV檢出率為100%（42/42）。與正常人及未發(fā)生HC的allo-HSCT受者相比，HC患者尿中BKV基因載量具有更高平均峰值?！〗Y(jié)論 Ⅱ~Ⅳ度aGVHD，尿中BKV DNA高載量與HC的發(fā)生有相關(guān)性?！続bstract】 Objective To identify the risk factors for hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT), and define the quantitative relationship between BK virus (BKV) DNA load with HC. Methods The medical records of 121 patients undergoing allo-HSCT from March 2003 to January 2008 were retrospectively analyzed. Eight clinical parameters were selected for COX regression analysis, including age, sex, underlying disease, disease status at transplant, donor type, conditioning regimen, acute graft-versus-host disease (aGVHD), and GVHD prophylaxis. From September 2006 to January 2008, mid-stream urine samples were continuously collected from 42 patients with allo-HSCT. SYBR green real-time polymerase chain reaction, technique was utilized to define the quantitative relationship between BKV DNA load and HC. Results Twenty-four out of 121 patients developed HC. The median time of onset was 40 days after HSCT, ranged from 0 to 63 days. The disease lasted for 7 to 150 days, with a median duration of 22 days. Grade Ⅱ-Ⅳ aGVHD [RR=8.304, 95% CI (1.223,56.396); P=0.030] was identified as an independent risk factor for the occurrence of HC. BKV excretion was detected in 100% (42/42) of the recipients of allo-HSCT. When compared with asymptomatic patients and allo-HSCT recipients without HC, patients with HC had a significantly higher mean peak BKV DNA load. Conclusions Patients are at an increased risk of developing HC if they have grade Ⅱ-Ⅳ aGVHD. A correlation between the load of BKV and incidence of HC may exist.