肝移植术后中远期巨细胞病毒的感染情况及诊治  

The epidemiological and clinical research of mid-long-term cytomegalovirus infection after liver transplantation

作　　者：黄云帆[1] 刘大平 陈虹[3] 王旭[3] 范铁艳[3] Huang Yunfan;Liu Daping;Chert Hong;Wang Xu;Fan Tieyan(Department of Critical Care Medicine,Chongqing Banan People＇s Hospital,Chongqing 401320,China;General surgery,Qujing Affiliated Hospital of Kunming General Hospital of PLA,Qujing 100039,Yunnan,China;Organ Transplantation Institute,General Hospital of Chinese People＇s Armed Police Forces,Beijing 100039,China)

机构地区：[1]重庆市巴南区人民医院重症医学科,重庆401320 [2]解放军昆明总医院曲靖分院普通外科,云南曲靖655000 [3]武警总医院器官移植研究所,北京100039

出　　处：《实用器官移植电子杂志》2018年第3期187-191,共5页Practical Journal of Organ Transplantation(Electronic Version)

摘　　要：目的探讨肝移植术后中远期巨细胞病毒(CMV)感染的发生情况、流行病学特点、临床表现及诊治的特殊性。方法回顾性分析2005年1月—2012年4月期间武警总医院移植研究所进行肝移植术患者术后中远期发生CMV的感染情况。血清学检测CMV免疫球蛋白M(CMV-IgM)及免疫球蛋白G(CMV-IgG),抗原检测CMV抗原(CMV-pp65),荧光定量PCR技术检测CMV脱氧核糖核酸(CMV-DNA)。结果期间共行肝移植术736例,术后中远期感染发生163例,感染的发生率为22.1%;其中CMV感染14例,感染的发生率为1.9%。CMV感染多发生于术后1~86个月,平均时间为7个月。结论肝移植术后中远期感染的发生率较早期明显降低,而CMV是肝移植术后一个较为常见的病毒感染,肝移植术后患者发生CMV感染的时间可能会随着预防方案的普遍运用而延后。肝移植术后中远期巨细胞病毒感染是一个不容忽视的问题,需提高认识和诊断能力。Objective To investigate the incidence, epidemiological characteristics, the clinical features and the treatment of mid-long-term cytomegalovirus（CMV） infection after liver transplantation. Methods The patients with mid-long-term cytomegalovirus infection after liver transplantation in the Armed Police General Hospital between January 2005 and April 2012 were analyzed retrospectively. CMV immunoglobulin M（CMV-Ig M） and immunoglobulin G（CMV-Ig G） were detected by serological method. CMV antigen（CMV-pp65）was detected by immulogical stain,and CMV-DNA was detected by fluorescent quantitative PCR. Results A total number of 736 cases of liver transplantation were performed, and 163 cases of postoperative infection occurred. The overall incidence was 22.1%. Among them, there were 14 cases of CMV infection the incidence of which was 1.9%. CMV infection occurred between 1-86 month after the operation, and the average time of CMV infection was 7 months. Conclusion Mid-long-term CMV infection after liver transplantation is a problem that cannot be ignored, and the abilities of recognition and diagnosis should be improved.

关 键 词：肝移植 感染 巨细胞病毒 

分 类 号：R511[医药卫生—内科学] R657.3[医药卫生—临床医学]