肾移植后人类细小病毒B19感染及与贫血关系研究  

Human parvovirus B19 infection-associated anemia in renal transplant recipients: a review of 144 cases

作　　者：孝晨[1] 刘龙山[2] 傅茜[3] 王长希[3] 

机构地区：[1]武警广东省总队医院肾脏病与血液净化中心,广东广州510507 [2]中山大学第一附属医院器官移植实验室,广东广州510008 [3]中山大学第一附属医院器官移植科,广东广州510008

出　　处：《中国病毒病杂志》2012年第1期53-57,共5页Chinese Journal of Viral Diseases

摘　　要：目的调查肾移植术后人类细小病毒B19(HPV B19)感染状况及其与移植后贫血的关系。方法随机抽取肾移植术后18个月内患者144例,定期检查HPV B19DNA拷贝数、抗体水平,并与同期普通体检者89例比较。以DNA结果将肾移植者分为感染组和非感染组,比较两组贫血状况。结果本研究144例患者中有27例确诊感染HPV B19,117名未感染,感染率为18.75%,显著高于同期普通人群(2.25%),差异有统计学意义(P<0.05)。感染组和非感染组盆血发生率、血红蛋白水平[(111.26±30.03)g/L vs(121.94±26.39)g/L]比较,差异有统计学意义。2例HPV B19DNA阳性者经骨髓穿刺证实为单纯红细胞再生障碍性贫血(PRCA),经免疫调节治愈。结论肾移植后早期患者HPV B19感染率较普通人群明显增高;肾移植后HPV B19感染与贫血相关,并可造成PRCA;肾移植后HPV B19感染相关的PRCA采用免疫调节治疗效果良好。Objective To investigate human parvovirus（HPV） infection and its association with anemia in post-renal transplant recipients.Methods A total of 144 patients were followed-up after renal transplantation at 1-18 months.The copy number of HPV-B19 DNA and the level of IgG,IgM antibodies were detected and compared to that in normal population.Anemia was determined by the level of blood hemoglobin（Hb） and partially by bone marrow biopsy.Results HPV-B19 infection was diagnosed in 27（18.75%） but not the other 117 patients which is much higher that in normal controls（2.25%）.Among the 144 post kidney transplant recipients,the Hb levels in the HPV infection group was much lower than that in the non-infection group（111.26±30.03 vs 121.94±26.39 g/L,P0.05）.Two HPV-B19 DNA positive patients were confirmed as the red cell aplasia（PRCA） by bone marrow biopsy and cured with immune therapy.Conclusions HPV-B19 infection after renal transplantation is a serious issue in the clinical practice.The HPV-B19 infection is highly related with anemia or PRCA.Immune therapy is effective in the treatmetn of PRCA cases.

关 键 词：肾移植 人类细小病毒B19 贫血 单纯红细胞再生障碍性贫血 

分 类 号：R556.5[医药卫生—血液循环系统疾病]