肾移植后BK病毒相关性肾病的早期诊断  

Early diagnosis of BK virus associated nephropathy after renal transplantation

作　　者：韩永[1] 蔡明[1] 钱叶勇[1] 王新颖[1] 黄海燕[1] 许晓光[1] 肖漓[1] 周文强[1] 冯凯[1] 石炳毅[1] 

机构地区：[1]解放军309医院全军器官移植中心研究室,北京市100091

出　　处：《中国组织工程研究》2012年第53期9916-9920,共5页Chinese Journal of Tissue Engineering Research

基　　金：十一五国家科技支撑计划基金项目(2008BAI60B04);课题名称:抗排斥关键诊疗技术的开发研究~~

摘　　要：背景:联合检测对于早期诊断BK病毒相关性肾病有着重要意义,目前研究较少。目的:探讨肾移植后联合检测诊断BK病毒相关性肾病的方法,并初步分析其临床应用价值。方法:留取84例肾移植患者的尿液和外周血标本,进行BK病毒感染负荷的实时荧光定量PCR和尿液巴氏染色检测,同时进行移植肾病理穿刺病理组织学及免疫组化检测,用于早期诊断BK病毒相关性肾病。结果与结论:2例患者诊断为BK病毒相关性肾病,占移植肾活检病例的2.5%。2例患者证实BK病毒相关性肾病后予以免疫抑制剂减量,肾功能明显好转。结果显示以上方法联合检测可提高BK病毒相关性肾病的诊断率,简便、可靠、准确,为进一步研究BK病毒感染与肾移植后移植物丢失的关系奠定了基础。BACKGROUND： Combination detection has clinical values in the early diagnosis of BK virus associated nephropathy （BKVAN） after renal transplantation. But the studies on it are rare. OBJECTIVE： To establish the combination detection method for BKVAN after renal transplantation, and to discuss the pathological features and clinical characteristics of BKVAN. METHODS： Peripheral blood and urine samples of 84 renal transplantation recipients were selected. A variety of methods were used in this study that comprised the quantitative real-time PCR method of detecting BK viral load in both urine and serum samples, the Papanicolaou staining for urine bait cells, pathologically biopsy and immunohistochemistry approach for renal biopsy tissues. All the methods were used for the early diagnosis of BKVAN. RSSULTS AND CONCLUSION： Two patients were diagnosed with BKVAN, accounting for 2.5% of the renal allograft participants. The renal function of the two confirmed BKVAN patients improved significantly following the reduction of immunosuppressive agents. The combined detection methods can improve the diagnosis of BKVAN with higher accuracy, feasibility and paved the way for further research about the relationship between the BKV pathogen infection and the loss of renal allografts.

关 键 词：移植肾肾病 肾移植 BK病毒 巴氏染色 实时荧光定量PCR 病理学 

分 类 号：R617[医药卫生—外科学]