目的　探讨儿童异基因造血干细胞移植（allo-HSCT）后巨细胞病毒（CMV）感染的危险因素及临床相关特征。 方法　收集2016年1月至2018年12月共269例allo-HSCT患儿的临床资料。监测移植后全血CMV-DNA拷贝数，分析 移植患儿CMV感染发生率、发生时间、危险因素及预后。结果　269例患儿中，男167例、女102例，中位年龄65个月 （33~115个月），其中165例发生CMV感染，感染率为61.3%，感染发生时间为移植后23 d（15~34 d），感染持续时间 38 d（25~66 d）。Logistic回归分析发现患儿移植年龄>65个月、移植后发生Ⅱ~Ⅳ级aGVHD是发生CMV感染的危险因 素，而亲缘全相合移植能降低CMV感染发生风险（P<0.05）。 发生Ⅱ~Ⅳ级急性移植物抗宿主病（aGVHD）及使用脐血移 植与发生难治性CMV感染相关（P<0.05）。 难治性CMV感染组与非难治性CMV感染组总体生存率及无病生存率的差异 有统计学意义（P<0.05）。 结论 移植患儿年龄大、Ⅱ~Ⅳ级aGVHD能增加CMV感染的发生风险，亲缘全相合移植能降低 CMV感染的发生风险。脐血移植后易发生难治性CMV感染；难治性CMV感染初次检测到CMV感染时间早，峰值高。

Objective　To explore the risk factors and clinical characteristics of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children. Methods　The clinical data of allo-HSCT in 269 children from January 2016 to December 2018 were collected. The copies of CMV-DNA in whole blood after transplantation were monitored. The incidence, time, risk factors, and prognosis of CMV infection were analyzed. Results　A total of 269 cases (167 males and 102 females) were included and median age was months (33 - 115 months). Among them, 165 cases had CMV infection and the infection rate was 61.3%. The infection occurred 23 days (15 - 34 days) after transplantation, and the infection lasted 38 days (25 - 66 days). Multivariate logistic regression analysis showed that transplantation age > 65 months and grade Ⅱ-Ⅳ aGVHD after transplantation were risk factors for CMV infection, while sibling donor hematopoietic stem cell transplantation (Sib-HSCT) could reduce the incidence of CMV infection (P < 0.05). The occurrence of grade Ⅱ-Ⅳ aGVHD and the use of cord blood transplantation are associated with the incidence of refractory CMV infection (P < 0.05). The difference of the overall survival rate and disease-free survival rate between the refractory CMV infection group and the non-refractory CMV infection group was statistically significant (P < 0.05). Conclusion　The risk of CMV infection can be increased by older children and Ⅱ-Ⅳ aGVHD, while the risk can be reduced by Sib-HSCT. Refractory CMV infection was likely to occur after umbilical cord blood transplantation, and the initial detection time of refractory CMV infection was early and the peak value was high.