亲属活体肾移植受者新型冠状病毒肺炎一例报告及临床特征分析  

Clinical case analysis of 2019 coronavirus disease (COVID-19) with living-related kidney transplantation

作　　者：卢峡[1] 明长生[1] 文志向[1] 仇丽茹 许淑云[3] 陈韬 宁琴[4] 罗小平[2] 陈知水[1] 宫念樵[1] Lu Xia;Ming Changsheng;Wen Zhixiang;Qiu Liru;Xu Shuyun;Chen Tao;Ning Qin;Luo Xiaoping;Chen Zhishui;Gong Nianqiao(Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Key Laboratory of Organ Transplantation,Ministry of Education,NHC Key Laboratory of Organ Transplantation,Key Laboratory of Organ Transplantation,Chinese Academy of Medical Sciences,Wuhan 430030,China;Department of Pediatrics,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of respiratory medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of infection,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,教育部器官移植重点实验室,国家卫生健康委员会器官移植重点实验室,中国医学科学院器官移植重点实验室,武汉430030 [2]华中科技大学同济医学院附属同济医院儿科,武汉430030 [3]华中科技大学同济医学院附属同济医院呼吸内科,武汉430030 [4]华中科技大学同济医学院附属同济医院感染科,武汉430030

出　　处：《中华器官移植杂志》2020年第3期148-151,共4页Chinese Journal of Organ Transplantation

基　　金：国家高技术研究发展计划(863计划)子项目(2012AA021010);中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2018PT32018);国家自然科学基金(81873623)。

摘　　要：目的:分析亲属活体肾移植受者发生COVID-19的临床特征。方法:回顾性分析华中科技大学同济医学院附属同济医院1例亲属活体肾移植受者发生COVID-19后临床诊治经过,包括起病经过、临床表现、实验室及影像学检查(包括血常规检查、肾功能检查、2019-nCoV核酸检测和肺部CT平扫)、治疗方案及转归。结果:本例肾移植受者在流行病学调查、临床表现、实验室检查、影像学表现和病原学检查方面具备典型COVID-19特征,诊断为COVID-19(重型)合并A型流感病毒感染。通过减停免疫抑制剂、阿比多尔/奥司他韦抗病毒、预防细菌感染、激素抗炎、吸氧、营养支持和充分休息等治疗,临床症状逐步缓解,肺部病灶吸收,达到临床治愈。结论:亲属活体肾移植受者具有特定免疫抑制状态,COVID-19对受者的长期影响需要继续随访观察。Objective To explore the clinical characteristics of one living-related kidney transplant recipient infected with 2019 coronavirus disease(COVID-19).Methods The clinical diagnosis and treatment of one living-related kidney transplant recipient after the occurrence of COVID-19 were analyzed retrospectively.Course of onset,clinical manifestations,laboratory and image enamination,outpatient and inpatient therapies and outcomes.Results The renal transplant recipient was diagnosed as COVID-19(severe)with influenza A virus infection based upon epidemiological survey,clinical manifestations,laboratory examinations,imaging findings and etiological tests.The clinical symptoms were gradually relieved and lung lesions became absorbed after tapering and withdrawing immunosuppressants,antiviral therapy of abidol/oseltamivir,antibiotic therapy,hormonal anti-inflammation,oxygen inhalation,nutritional supports and adequate rest.Conclusions Living-related kidney transplant recipients have specific immunosuppressive states.The long-term effect of covid-19 on recipients should be determined through long-term follow-ups.

关 键 词：肾移植 新型冠状病毒肺炎 免疫抑制 

分 类 号：R699.2[医药卫生—泌尿科学] R563.1[医药卫生—外科学]