2种抗病毒药物预防肾移植术后巨细胞病毒肺炎的疗效及安全性探讨  

Analysis of the efficacy and safety of two antiviral drugs in prevention of CMV pneumonia in kidney transplant recipients

作　　者：费琳[1,2] 胡征[2] 吴丹丹[3] 刘进[3] 

机构地区：[1]浙江大学附属第二医院呼吸科,杭州310009 [2]浙江省慈溪市人民医院呼吸内科,慈溪315300 [3]浙江大学附属第二医院感染性疾病科,杭州310009

出　　处：《中国抗生素杂志》2015年第10期776-779,共4页Chinese Journal of Antibiotics

摘　　要：目的评价2种抗病毒药物预防肾移植术后巨细胞病毒(cytomegalovirus,CMV)肺炎的效果和安全性。方法对未使用抗病毒药物或预先应用喷昔洛韦(penciclovir,PCV)或缬更昔洛韦(valganciclovir,VGC)的肾移植受者进行回顾性研究,探讨上述药物对肾移植术后CMV肺炎的预防效果和安全性。结果共82例肾移植受者的临床资料纳入本项研究。术后6个月内,VGC组、PCV组和空白对照组(Sham组)患者CMV肺炎发病率分别为27.5%,18.9%和56.3%,差异有统计学意义(P<0.05),其中VGC组和PCV组间无统计学差异(P>0.05)。治疗12个月后,VGC组、PCV组和Sham组患者CMV肺炎发病率分别为6例(20.6%),5例(13.5%)和3例(18.7%),各组间无统计学差异(P>0.05)。进一步研究发现,治疗6个月后,VGC组、PCV组和Sham组患者重症CMV肺炎发病率分别为13.8%,0和12.5%,其中PCV组重症CMV肺炎发病率较其他2组显著降低(P<0.05)。结论 PCV可以预防肾移植术后CMV肺炎的发生。与VGC相比,PCV对术后早期重症CMV肺炎的预防效果可能更为显著。Objective To evaluate the efficacy and safety of two antiviral drugs in the prevention of CMV pneumonia in kidney transplant recipients. Methods In accordance with the drug use in our hospital, the recipients are divided into 3 groups： penciclovir（PCV） group, valganciclovir（VGC） group and Sham group. The clinical data were retrospectively analyzed to investigate the efficacy and safety of the above-mentioned daalgs in the prevention of CMV pneumonia post kidney transplant. Results A total of 82 patients who underwent the antiviral drugs or not after surgery at 6 and 12 month were included in the monitoring. The coincidence of CMV pneumonia post kidney transplant at 6 month in PCV group, VGC group and Sham group werel8.90%, 27.50% and 56.30%, respectively. The difference showed statically significance（P〈0.05）. There was no statistical significant difference between PCV group and VGC group（P〉0.05）. Follow-up 12 months, the difference of incidence between 3 groups weren＇t statistically significant（P〉0.05）. Further study revealed the coincidence of severe CMV pneumonia in PCV group, VGC group and Sham group was 0, 13.80% and 12.50%, respectively. The incidence was significantly reduced in PCV group compared with other 2 groups（P〈0.05）. Conclusion PCV may be effective to the prevention of CMV pneumonia post kidney transplant. It has an advantage over VGC in prevention of severe CMV pneumonia. But the conclusion is preliminary and subjected to be tested.

关 键 词：喷昔洛韦 缬更昔洛韦 巨细胞病毒 肺炎 肾移植 

分 类 号：R978.7[医药卫生—药品]