便细胞巨乳病毒阳性患者的临床特征和预后因素
Yi-Tien Hsuan1,2, Ching-Hao Hsu1,2,3, Cheng-Yu Chen4,5
1Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Journal of the Chinese Medical Association : JCMA
|September 29, 2025
概括
高便或血细胞巨乳病毒 (CMV) DNA水平预测肠道CMV重新激活患者的30天死亡率. 抗病毒治疗的持续时间是保护性的,而败血症和类固醇使用会增加死亡风险.
科学领域:
- 传染性疾病 传染性疾病
- 病毒学 病毒学
- 临床医学 临床医学
背景情况:
- 便样本中细胞巨乳病毒 (CMV) DNA 的预后意义尚不清楚.
- 这项研究调查了便中CMV聚合酶链反应 (PCR) 阳性患者的预后因素和病毒动力学.
研究的目的:
- 评估肠道CMV再激活患者的预后因素和病毒动力学.
- 评估便和血CMV病毒载荷对30天死亡率的预测值.
主要方法:
- 成年患者的回顾性队列研究,便CMV-PCR (2016-2021) 呈阳性.
- 临床数据,血和便病毒载荷 (VLs) 的分析.
- 接收器运行特征 (ROC) 曲线和Cox比例危险模型用于确定30天死亡率的预测因素.
主要成果:
- 便CMVVL (>9,654副本/毫升) 和血CMVVVL (>1,738副本/毫升) 的升高独立预测了30天死亡率.
- 在便和血CMVVVL之间观察到中度相关性 (ρ = 0.38,p < 0.0001).
- 败血症休克和类固醇使用增加了死亡风险;抗病毒疗法≥7天具有保护性 (调整HR:0.26).
结论:
- 便和血CMV病毒载荷,抗病毒治疗持续时间和宿主免疫状况是影响肠道CMV重新激活结果的关键因素.
- 需要进一步的研究来验证风险分层的最佳病毒载荷值.
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