膦甲酸钠治疗与预防肾移植后巨细胞病毒感染的临床研究  

A CLINICAL STUDY ON FOSCARNET IN THE PROPHYLAXIS AND TREATMENT OF CMV INFECTION AFTER KIDNEY TRANSPLANTATION

作　　者：徐达[1,2,3] 王祥慧[1,2,3] 丁言德[1,2,3] 唐孝达 谢桐[1,2,3] 蒋金根 凌建煜[1,2,3] 

机构地区：[1]上海市第一人民医院泌尿外科 [2]上海医科大学中山医院 [3]上海第二医科大学瑞金医院

出　　处：《肾脏病与透析肾移植杂志》1998年第6期526-529,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的：研究膦甲酸钠在肾移植术后巨细胞病毒（ＣＭＶ）感染的治疗及预防中的作用，及患者的耐受性。方法：对１９９５年９月～１９９６年６月间１２０例肾移植术后ＣＭＶ感染患者，按照临床症状分期及实验室检查进行临床对照研究。实验组使用膦甲酸钠，对照组为Ｚｏｖｉｒａｘ，疗程为３～４周，治疗后随访３个月评估疗效。结果：静止期ＣＭＶ感染者，空白对照组３３．３％（８／２４）发生ＣＭＶ的活动性感染，而实验组无一例发生。活动期ＣＭＶ感染者，实验组ＣＭＶ－ＩｇＭ抗体转阴率为９２．９％（３９／４２），对照组为６５．４％（１７／２６），Ｐ＜０．０５。实验组中有４例产生一过性轻度肾功能损害，无其它严重并发症发生。结论：膦甲酸钠对肾移植术后ＣＭＶ感染者有显著的治疗和预防作用。OBJECTIVE To study the effect of Foscarnet in the prophylaxis and treatment of CMV infection after kidney transplantation and the side effect of Foscarnet in treatment. METHODOLOGY A clincial control trial was undertaken in 120 patients with CMV infection after renal transplantation.Patients were grouped according to the clinical stages and symptoms.Foscarnet and Zovirax were used in the test group and control group for 3～4 weeks,respectively,After 3 months follow up,the clinical results were compared and evaluated. RESULTS 33 3%(8/24)of static CMV infection patients in the control group became active,none in test group(0/28).92 9%(39/42)of active CMV infection patients treated with Foscarnet turned into negative,while 65 4%(17/26)of active CMV infection patients treated with Zovirax became negative.The difference of conversion rates between the two groups was significant( P <0 05).In four patients taking Foscarnet,a transient slight renal function impairment was observed.No other severe complications occurred in this study. CONCLUSION Foscarnet is effective in the prevention and treatment of CMV infection in renal transplant patients with satisfactory safety and patient tolerance.

关 键 词：膦甲酸钠 巨细胞病毒 肾移植 治疗 预防 

分 类 号：R699.2[医药卫生—泌尿科学] R511[医药卫生—外科学]