肾移植术后JC病毒感染诊断与治疗  

Diagnosis and treatment of JC virus infection after renal transplant

作　　者：韩永[1] 蔡明[1] 周文强[1] 王强[1] 王宏阳[1] 许亮[1] 肖漓[1] 冯凯[1] 石炳毅[1] 

机构地区：[1]解放军第309医院全军器官移植研究所器官移植与免疫调节北京市重点实验室,北京100091

出　　处：《中华实用诊断与治疗杂志》2013年第8期744-746,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家科技支撑计划基金项目(2008BAI60B04)

摘　　要：目的探讨肾移植术后患者联合检测诊断JC病毒相关性移植肾肾病的临床应用价值。方法 89例肾移植术后患者移植肾,采用组织病理学及SV-40大T抗原免疫组织化学方法、实时荧光定量PCR技术检测尿液和外周血标本JC病毒感染负荷,采用尿液巴氏染色技术检测尿中"诱饵细胞"。结果 89例患者共检出JC病毒尿症阳性17例(19.1%),首次发生病毒尿症的中位时间为肾移植术后3个月,未发现JC病毒血症;17例JC病毒尿症阳性者均可见明显decoy细胞形态;89例患者SV-40大T抗原免疫组织化学染色均阴性。结论肾移植后JC病毒感染与多种因素有关,联合检测可提高JC病毒相关性肾病的诊断率。Objective To explore the clinical application of combined detection of JC virus in the diagnosis of associated nephropathy after renal transplant. Methods Blood and urine samples of the 89 renal transplantation recipients were detected the viral load of polyomavirus JC by using histopathology method, immunohistochemical method with SV-40 large T antigen and real-time quantitative PCR. While the decoy cells shedding into urine were detected with Papanicolaou staining method. Results JC viruria was positive in 17 patients （19.1%） and the median time for the first time was 3 months after renal transplant, and no viremia was detected. The decoy ceils were clearly evident in urine of the 17 recipients with positive JC viruria. The biopsy specimens from all of the 89 enrolled recipients were stained negative with antibodies against SV40 large T antigen protein. Conclusion JC-virus infection after renal transplant is associated with many factors. The combined detection methods can improve the diagnosis rate of JC virus-associated nephropathy.

关 键 词：肾移植 实时荧光定量PCR JC病毒 移植肾肾病 

分 类 号：R699[医药卫生—泌尿科学]