JC病毒在肾移植受者中的感染状况  

JC virus infection in kidney transplant recipients

作　　者：胡建华[1] 赵宏[1] 张旋[1] 高海女[1] 杨美芳[1] 马亚丹[1] 李敏环[1] 黄雅萍[1] 范骏[1] 马伟杭[1] 

机构地区：[1]浙江大学医学院附属第一医院,传染病诊治国家重点实验室,杭州310003

出　　处：《中华微生物学和免疫学杂志》2010年第7期670-673,共4页Chinese Journal of Microbiology and Immunology

基　　金：基金项目：国家重点基础研究发展计划（973计划）资助项目（2007CB513005）;浙江省医药卫生科学研究基金（2007A058）;浙江省医药卫生科学研究基金（2002ZX028）;浙江省中医药科研计划资助项目（移植术后BK病毒感染早期诊断和抗病毒中药预防研究）

摘　　要：目的 探究多瘤JC病毒（JC virus,JCV）在肾移植受者中的感染情况及其感染对移植肾功能的影响,并初步探索JCV感染的影响因素.方法 采用巢式PCR方法检测49例肾移植病人术后尿液标本中的JCV DNA,并以24例健康体检者为对照;定性PCR方法检测病人尿液标本中的巨细胞病毒（cytomegalovirus,CMV）DNA;Binary Logistic回归方法分析JCV感染的可能影响因素：病人的年龄、性别、免疫抑制方案、CMV感染;以肾小球滤过率（glomerular filtration rate,GFR）作为肾功能的指标,t检验方法比较JCV感染和非感染者GFR有无差别.结果 JCV在肾移植病人中的感染率为42.9%,健康体检者为4.2%.移植后CMV感染和强的松＋MMF＋环孢素三联免疫抑制方案是JCV感染的危险因素（OR=10.101,P=0.049;OR=6.286,P=0.008）.JCV感染者和非感染者的GFR分别为86.470±29.990和84.060±33.729,两者间的差异无统计学意义（t=0.259,P=0.797）.结论 JCV在肾移植病人中有很高的感染率,CMV感染和使用强的松＋MMF＋环孢素三联免疫抑制方案可明显增加JCV感染的危险性;JCV感染对移植肾功能无影响.Objective To investigate JC virus（JCV） infection in kidney transplant recipients and its influence on graft function and also initially explore JCV infection factors. Methods A total of 49 kidney transplant recipients and 24 health examination persons were enrolled in our study, JCV DNA was measured using nested qualitative polymerase chain reaction assays of urine, while CMV DNA was measured by common qualitative polymerase chain reaction assays of urine. JCV infection factors, such as age, male, immunosuppressive therapy, cytomegalovirus（CMV） infection were analyzed by Binary Logistic Regression, and glomerular filtration rate（GFR） was selected as a index of kidney function and the difference of GFR between JCV-infected and non-infected patients was compared using t test. Results JCV was detected in 42.9% of kidney transplant patients and 4.2% health examination persons. CMV infection and Pred ＋ MMF ＋ CsA triple immunosuppressive regimen were found to be the risk factors of JCV infection. No difference of GFR was observed between JCV infected and non-infected patients （86.470 ± 29.990 and 84.060 ± 33. 729 for each; t =0. 259, P =0.797）. Conclusion JCV is frequently detected in kidney transplant recipients. CMV infection and using of Pred ＋ MMF ＋ CsA triple immunosuppressive regimen can significantly increase the risk of JCV infection. While, graft function was not influenced by JCV infection in kidney transplant patients.

关 键 词：JC病毒 移植 尿液 感染 

分 类 号：R699[医药卫生—泌尿科学]