实体器官移植术后真菌感染的防治  

Prevention and treatment of fungal infection after solid organ transplantation

作　　者：邓斐文[1] Deng Feiwen(Department of Hepatopancreas Surgery,the First People’s Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院肝脏胰腺外科,广东佛山528000

出　　处：《器官移植》2022年第4期442-448,共7页Organ Transplantation

基　　金：广东省基础与应用基础研究基金联合基金重点项目(2020B1515120031);佛山市医学类科技攻关项目(2018AB003501)。

摘　　要：经过近70年的发展,器官移植已经成为多种终末期疾病的有效治疗手段。但器官移植受者术后需服用免疫抑制剂,导致免疫功能低下,感染的发生率较高,包括病毒、细菌和真菌感染。其中真菌感染发病较隐蔽,早期诊断较困难,假丝酵母、曲霉、隐球菌、肺孢子菌感染是实体器官移植中比较常见的真菌感染。识别实体器官移植术后真菌感染的高危因素,提前预防,术后结合1,3-β-D葡聚糖试验(真菌G试验)、影像学检查和相关体液培养结果,做到早期诊断、早期治疗,对降低实体器官移植术后真菌感染的发生率及相关的病死率具有较大的临床意义。本文就器官移植术后常见的真菌感染进行综述,以期为器官移植术后真菌感染的防治提供参考。Over nearly 70-year development,organ transplantation has become an effective treatment for multiple end-stage diseases.However,postoperative administration of immunosuppressants should be given for the recipients,which leads to low immune function and high incidence rate of infection,including viral,bacterial and fungal infections.Among them,the occurrence of fungal infection is hidden,and it is difficult to deliver prompt diagnosis.Candida,Aspergillus,Cryptococcus and Pneumocystis infection are common fungal infections in solid organ transplantation.High-risk factors of fungal infection after solid organ transplantation should be identified and prevented in advance,and prompt diagnosis and treatment should be carried out by combining the results of(1,3)-β-D-glucan assay(fungal G-test),imaging examination and related body fluid culture.These interventions are of clinical significance to reduce the incidence of fungal infection and fatality after solid organ transplantation.In this article,common fungal infections after organ transplantation were reviewed,aiming to provide reference for the prevention and treatment of fungal infections after organ transplantation.

关 键 词：器官移植 真菌感染 假丝酵母 曲霉 隐球菌 肺孢子菌 棘白菌素 两性霉素B 

分 类 号：R617[医药卫生—外科学] R379[医药卫生—临床医学]