肾移植患者活动性巨细胞病毒感染临床研究  

Regularity of active cytomegalovirus infection after renal transplantation

作　　者：王平贤[1] 黄赤兵[1] 范明齐[1] 张艮甫[1] 

机构地区：[1]第三军医大学新桥医院泌尿外科,重庆400037

出　　处：《重庆医学》2006年第15期1352-1354,共3页Chongqing medicine

摘　　要：目的明确肾移植患者术前巨细胞病毒（CMV）感染的发生率和术后活动性CMV感染的发生规律。方法检测55例健康成人以及我院2002年3月～2005年8月期间377例尿毒症患者肾移植前血清抗CMV抗体（抗CMV-IgG、CMV-IgM）；观察肾移植后CMV-pp65抗原血症的动态变化。结果55例健康成人抗CMV-IgG的阳性率为69．1％、血清抗CMV-IgM均为阴性、外周血CMV-pp65（＋）白细胞数为0～4个／5×10^4 WBC；尿毒症患者术前CMV—IgG、CMV-IgM阳性率分别为94．2％、6．9％，肾移植术后6个月内，患者外周血CMV—pp65（＋）白细胞数为0～3142个／5×10^4 WBC（其中〉5例占86．7％），其高峰期在术后第6～8周。结论肾移植受者术前CMV感染发生率明显高于健康人群，且约有6．9％存在着活动性CMV感染；肾移植患者术后6个月内，活动性CMV感染发生率高达86．7％；术后第6～8周是活动性CMV感染最严重的时期。Objective To investigate the incidence of active CMV infection before renal transplantation,and the regularity of active CMV infection after renal transplantation. Methods Serum antibodies of CMV-IgG and CMV-IgM were detected for 55 persons in control group, and for 377 uremia patients before renal transplantation. The variations of number of pp65 positive cells in peripheral blood in patients after renal transplantation were determined. Results Serum antibodies of CMV-IgM were all negative, and the rate of CMV-IgG positive was 69.1%, and number of pp65 positive cells in peripheral blood was 0--4/5 × 10^4 WBC. The positive rates of CMV-IgG and CMV-IgM were 94.2% and 6.9% respectively, and the number of pp65 positive cells in peripheral blood was 0--3 142 cells/5 × 10^4 WBC in patients after renal transplantation. The peak time of the number of pp65 positive cells in peripheral blood was sixth to eighth week after renal transplantation. Conclusion The findings suggest that incidence of active CMV infection before renal transplantation is at least 6.9%. It is higher than that in control group. The difference was significant. Active CMV infection has a great incidence which is 86.7% in the first 6 months after renal transplantation. The period of time when active CMV infection is most serious is from sixth to eighth week after renal transplantation.

关 键 词：肾移植 巨细胞病毒 

分 类 号：R699.2[医药卫生—泌尿科学]