实体器官移植术后隐球菌感染诊治的研究进展  

Progress in diagnosis and treatment of cryptococcosis associated with solid organ transplantation

作　　者：杜安通 周兆婧 郭天阳[1,2] 廖万清[2] 方伟[2,3] 

机构地区：[1]第二军医大学学员旅,上海200003 [2]第二军医大学附属长征医院皮肤科,上海200003 [3]上海市医学真菌分子生物学重点实验室,上海200003

出　　处：《微生物与感染》2015年第2期122-126,共5页Journal of Microbes and Infections

基　　金：国家重点基础研究发展计划(2013CB531601);上海市自然科学基金(12ZR1454400;12JC1411000);上海市医学真菌分子生物学实验室基金(14DZ2272900)

摘　　要：隐球菌是实体器官移植术后最常见的致病性真菌之一,主要通过呼吸道入侵机体并播散至全身,尤嗜中枢神经系统。隐球菌感染如不及时治疗,病死率极高。实体器官移植术后隐球菌感染的主要危险因素包括术前发热、术后免疫抑制剂和抗生素使用、术后导管留置时间、术后感染及大剂量糖皮质激素使用等。其临床症状缺少特异性,早期诊断较困难。实体器官移植术后抗隐球菌治疗主要包括两性霉素B、氟胞嘧啶、氟康唑等,具体方案通常视患者免疫状态和器官功能而定。本文综述了实体器官移植术后隐球菌病诊断和治疗方面的研究进展。Cryptococcus neoformans species complex is one of the most common fungal pathogens for solid organ transplantation ,which invades the host mostly through respiratory tract and then disseminated to remote organs especially central nervous system .Without prompt treatment ,cryptococcal infection has very high mortality and morbidity .The main risk factors include preoperative fever ,postoperative application of antibiotics and immunosuppressors ,postoperative bacterial and （or ） viral infection ,and the large dose use of glucocorticoid . Due to its lack of unique clinical features , it is difficult to make early diagnosis of cryptococcal infection .At present ,amphotericin B ,fluconazole and flucytosine are still the first‐line drugs . The exact therapeutic regimen depends on the immune status and organ function of the host .This review mainly focuses on the progress in the diagnosis and treatment of cryptococcal infection after solid organ transplantation .

关 键 词：隐球菌病 实体器官移植 危险因素 诊断 治疗 

分 类 号：R617[医药卫生—外科学] R519.4[医药卫生—临床医学]