肾移植术后尿中多瘤病毒BK的检测及意义  

Detection of BK virus in urine of renal allograft recipients and its significance

作　　者：闻立平[1] 陈江华[1] 

机构地区：[1]浙江大学医学院附属第一医院肾脏病中心

出　　处：《中华泌尿外科杂志》2006年第6期387-390,共4页Chinese Journal of Urology

摘　　要：目的探讨尿中多瘤病毒BK(BKV)检测在肾移植后BKV感染中的诊断价值。方法采用聚合酶链反应(PCR)结合测序方法检测61例肾移植后患者尿中BKV DNA,并与30例血液透析患者和30例健康志愿者尿液检测结果对照。结果肾移植组BKV DNA检出率为36.1% (22/61),明显高于血液透析组的13.3%(4/30)(P＜0.05),对照组检测均为阴性(P＜0.05)。1例BKV阳性肾移植患者出现输尿管梗阻。移植组发生排斥反应和未发生排斥反应患者的BKV DNA检出率分别为40.9%(9/22)和33.3%(13/39),P＞0.05；肾功能正常和异常者BKV DNA的检出率分别为36.0%(18/50)和36.4%(4/11),P＞0.05。结论肾移植患者是引起BKV尿的高危人群。肾移植后有无排斥反应史及肾功能正常与否与BKV尿无相关性。尿BKV检测可作为肾移植后BKV相关性输尿管梗阻的鉴别诊断和多瘤病毒相关性肾病的筛选方法。Objective To investigate the value of detecting BK virus （BKV） in urine of renal allograft recipients for the diagnosis and treatment of BKV infection. Methods Using polymerase chain reaction （PCR） method combined with DNA sequencing,61 urine samples from renal allograft recipients ,30 urine samples from dialytic patients and 30 urine samples from healthy volunteers （controls） were detected. The results were compared among the 3 groups. Results The BKV positive rate in renal allograft recipients was 36. i% ,compared with 13.3% in dialytic patients（P 〈0.05） and 0.0% in controls（P 〈0.05）. One renal allograft recipient who was positive for BKV developed ureteral obstruction, The BKV positive rate was 40.9% （9/22） in renal allograft recipients with rejection episode, compared with 33.3 % （13/39） in the recipients without rejection episode（ P 〉0.05 ） ;and the BKV positive rate was 36.0% （18/50） in the recipients with normal graft function,compared with 36.4% （4/11） in the recipients with abnormal graft function （P 〉 0.05）. Conclusions Renal allograft recipients are the high risk population who may develop BKV viruria. There is no correlation between recipients with or without rejection episode and BKV viruria,and also no correlation between recipients with normal or abnormal graft function and BKV viruria. Detection of BKV in the urine of renal allograft recipients is helpful in differential diagnosis of BKV induced ureteral obstruction, and PCR method for detecting BKV DNA can be used to screen for BK virus-associated nephropathy （BKVAN）.

关 键 词：肾移植 多瘤病毒 BK 

分 类 号：R699[医药卫生—泌尿科学]