肝炎病毒感染的肾移植受者术后并发症  

Postoperationalcompliacationsinrenalrecipientswithhepatitisvirusinfections

作　　者：董光富 张仕光[1,2] 吴培根[1,2] 郑克立[1,2] 

机构地区：[1]中山医科大学肾脏病研究所 [2]皖南医学院附属弋矶山医院肾内科

出　　处：《肾脏病与透析肾移植杂志》1996年第6期24-26,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的：了解ＨＢｓＡｇ或Ａｎｔｉ－ＨＣＶ阳性对肾移植受者术后并发肝外感染、急性排异及移植肾功能不全的影响。方法：回顾分析１０１例肾移植受者的临床资料。结果：在ＨＢｓＡｇ（＋）与Ａｎｔｉ－ＨＣＶ（＋）组间上述三大并发症发生率差异不显著（Ｐ＞０．０５）；ＨＢｓＡｇ（＋）组或Ａｎｔｉ－ＨＣＶ（＋）组移植肾急性排异及肾功能不全的发生率较高，尽管较阴性组无显著差异（Ｐ＞０．０５），但肝外感染的发生率明显升高（Ｐ＜０．０５）。结论：对ＨＢｓＡｇ（＋）或Ａｎｔｉ－ＨＣＶ（＋）的肾移植受者必须密切监测肝功能，环孢素Ａ（ＣｓＡ）浓度及机体免疫状态。BJECTIVESHepatitisvirusinfectionafterrenaltransplantationisconsideredasoneofthemajorfactorsasociatedwiththeprognosisofrenaltransplantrecipients,butithasnotyetbenconfirmedwhethertheposivityofHBsAgorAnti-HCVhasanyefectontheincidencesofextra-hepaticinfections,acuterejectionandrenalalograftdysfunctioninrenaltransplantpatients.METHODOLOGY101casesofrenaltransplantrecipientswereincludedinthisstudyandfolowedupatleastforsixmonths.Theclinicaldatawereretrospectivelyreviewed.AlthepatientsweredividedintoHBsAg(+)group(n=20),Anti-HCV(+)group(n=16)andHBsAg(-)/Anti-HCV(-)group(n=73).Theincidencesofextra-hepaticinfections,acuterejectionandrenalalograftdysfunctionwerecomparedbetwenthethreegroupswiththeapplicationofchi-squaretest.RESULTSHigherratesofacuterejectionandrenalalograftdysfunctionepisodewereobservedinHBsAg(+)groupandAnti-HCV(+)group,butnosignificantdiference(P>0.05)werefoundascomparedwithHBsAg(-)/Anti-HCV(-)group.Asignificantlyhigherrateofextra-hepaticinfections(P<0.05)wasobservedinHBsAg(+)orAnti-HCV(+)patientsascomparingwiththeHBsAg(-)/Anti-HCV(-)patients.Nosignificantdiference(P>0.05)inincidencesofextra-hepaticinfections,a-cuterejectionandrenalalograftdysfunctionwerefoundbetweenHBsAg(+)groupandAnti-HCV(+)group.CONCLUSIONSPatientswithHBsAgorAnti-HCVpositivityhaveahigherratesofextra-hepaticin-fections,andtendtohavemoreepisodesofacuterejectionandrenalalograftdysfunction.Itissuggest-edthatimmunosuppresivetherapyshouldbecautiouslymonitoredormodifiedreasonablyinHBsAg(+)orAnti-HCV(+)patientsafterrenaltransplantation.

关 键 词：病毒性肝炎 肾移植 肝炎病毒感染 并发症 

分 类 号：R512.6[医药卫生—内科学] R699.206[医药卫生—临床医学]