肾移植受者术后人类微小病毒B19感染39例的流行病学分析及防控  

Epidemiological analysis and prevention and control of human parvovirus B19 infection in 39 recipients of renal transplantation

作　　者：代林睿 王晓辉[2] 陈松[1] 邹志宇 邢欣彤 张伟杰[1] 昌盛[1] Dai Linrui;Wang Xiaohui;Chen Song;Zou Zhiyu;Xing Xintong;Zhang Weijie;Chang Sheng(Institute of Organ Transplantation,Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science&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 Urology,First Affiliated Hospital,Henan University of Science&Technology,Luoyang 471003,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,器官移植教育部重点实验室,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]河南科技大学第一附属医院泌尿外科,洛阳471003

出　　处：《中华器官移植杂志》2022年第10期603-610,共8页Chinese Journal of Organ Transplantation

基　　金：湖北省卫生计生委科研项目重点支撑项目(WJ2019Z007)。

摘　　要：目的分析总结肾移植受者术后近期感染人微小病毒B19(HPV-B19)的流行病学特点、危险因素及防治措施。方法回顾性分析华中科技大学同济医学院附属同济医院2020年5月至2021年6月肾移植术后感染HPV-B19的39例受者的流行病学特点、诊疗方法、防治措施及预后等,并以感染者手术时间相近而未感染的78例受者作为对照组进行危险因素分析。计算观察期间感染HPV-B19的4例肝移植受者的感染率,比较其与肾移植受者的差异。采用χ2检验、Fisher确切概率法等进行统计学分析。结果观察期间本中心共有368例受者接受肾移植手术,其中39例(10.60%)发生HPV-B19感染。临床症状方面,39例受者均表现出纯红细胞再生障碍性贫血(pure red cell aplasia,PRCA)。季节分布方面,秋冬季HPV-B19感染人数占全年74.3%(29/39),其中秋季为48.7%(19/39)。不同移植受者感染率比较,同期123例肝移植受者中有4例(3.25%)感染HPV-B19,感染率低于肾移植受者的10.60%(39/368),且差异有统计学意义(χ^(2)=6.225,P=0.013)。输注血液制品为术后近期感染的危险因素(χ^(2)=4.806,P=0.028,OR=2.418,95%CI=1.088~5.373)。结论肾移植受者感染HPV-B19后主要表现为PRCA且较肝移植受者更易感染。秋冬季节可能是HPV-B19易感季节,应增强防护来预防感染。输注血液制品为肾移植术后近期HPV-B19感染的危险因素,故要对供者进行常规检查并检测肾移植术后受者使用的血液制品安全。HPV-B19感染是可防可控的,切断传播途径能防止进一步播散,避免暴发流行。Objective To explore the epidemiological characteristics,risk factors,preventions and treatments of recent human parvovirus B19(HPV-B19)infections in recipients of renal transplantation(RT).Methods From May 2020 to June 2021,retrospective review was conducted for epidemiological characteristics,treatment protocols,preventions and outcomes of HPV-B19 infected recipients after RT.Risk factors were analyzed using uninfected recipients after RT in the same period as controls.And 78 recipients who were not infected after RT with similar operation time were used as a control group for risk factor analysis.The infection rates of the four liver transplant recipients infected with HPV-B19 during the same period were calculated and compared with those of the kidney transplant recipients.Chi-square test and Fisher's exact test were used for statistical analysis.Results During the observation period,HPV-B19 infection occurred in 39/368 recipients after RT with an overall infection rate of 10.60%(39/368).In terms of clinical symptoms,all 39 recipients presented with pure red cell aplasia(PRCA).In terms of season of infection,HPV-B19 infections occurred predominantly in autumn and winter[74.3%(29/39)of infections in autumn and winter,including 48.7%(19/39)in autumn].Comparing the infection rates of different transplant recipients,4 out of 123 liver transplant recipients were infected with HPV-B19 during the same period.The rate of infection was lower in liver transplant recipients than in RT counterparts(3.25%vs.10.60%,χ2=6.225,P=0.013).Analysis of OR values showed that transfusion of blood products was a risk factor for recent postoperative infection(χ2=4.806,P=0.028,OR=2.418,95%CI=1.088-5.373).Conclusions HPV-B19 infection in renal transplant patients is mainly manifested as PRCA and is more likely than in liver transplant patients.Autumn and winter may be susceptible seasons for HPV-B19 and protection should be increased to prevent infection.Transfusion of blood products is a risk factor for recent HPV-B19 infection after

关 键 词：肾移植 肾移植术后人类微小病毒B19感染 再生障碍性贫血 流行病学 

分 类 号：R699.2[医药卫生—泌尿科学]