山东某医院肝移植受者术后弓形虫感染现状调查  

INVESTIGATION OF POSTOPERATIVE TOXOPLASMA GONDII INFECTION AMONG LIVER TRANSPLANT RECIPIENTS IN A HOSPITAL IN SHANDONG PROVINCE,CHINA

作　　者：白文叶 薛宝梅 王中军[2] 张翔雁 李永欣[4] 田润华[2] BAI Wenye;XUE Baomei;WANG Zhongjun;ZHANG Xiangyan;LI Yongxin;TIAN Runhua(Department of Hepatobiliary Pancreatic Surgery,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院肝胆胰外科,山东青岛266003 [2]青岛大学附属医院检验科,山东青岛266003 [3]青岛大学附属医院病理科,山东青岛266003 [4]青岛大学附属医院血管外科,山东青岛266003

出　　处：《青岛大学学报（医学版）》2023年第2期246-249,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省自然科学基金资助项目(ZR2016HQ18)。

摘　　要：目的分析山东某医院近3年肝移植受者移植后血清弓形虫抗体含量及常见感染接触史,了解本地区肝移植受者术后弓形虫感染相关因素。方法选取2015年6月—2018年11月在青岛大学附属医院接受肝移植手术、术前弓形虫抗体检测阴性且术后自愿接受弓形虫抗体检测的210例病人作为病例组,同期随机选取与病例组年龄、性别相匹配的本院健康查体成人210例作为对照组。采用化学发光法对所有受试者血清弓形虫抗体(IgG和IgM)进行定量测定,并进行流行病学问卷调查。结果病例组及对照组血清弓形虫抗体阳性率分别为29.5%和9.5%,两组比较差异有统计学意义(χ^(2)=26.73,P<0.01)。肝移植受者术后弓形虫感染与养猫、生吃蔬菜、接触动物粪便及化疗史、接受抗肿瘤靶向治疗史有关(χ^(2)=4.23~30.10,P<0.05)。结论山东青岛地区肝移植受者术后弓形虫感染率明显高于健康成人,这可能与移植者免疫力下降及某些生活习惯有关。临床应定期监测肝移植病人血清弓形虫抗体含量,加强宣讲,以预防和控制移植后弓形虫感染。Objective To analyze the level of serum antibodies to Toxoplasma gondii(TOX)after transplantation and the common history of exposure to infections among liver transplant recipients in a hospital in Shandong Province,China in recent 3 years,and to investigate the factors related to postoperative TOX infection in liver transplant recipients in this area.Methods A total of 210 patients who underwent liver transplantation in The Affiliated Hospital of Qingdao University from June 2015 to November 2018,had negative preoperative TOX antibody test results,and voluntarily underwent TOX antibody test after operation were selected as the case group.In the same period,210 healthy adults who underwent physical examination in this hospital and matched the age and sex of the case group were randomly selected as the control group.The serum antibodies(IgG and IgM)to TOX in all subjects were measured quantitatively by the chemiluminescence method,and an epidemiological questionnaire survey was conducted.Results The positive rate of serum TOX antibodies in liver transplant recipients was significantly higher than that in controls(29.5%vs 9.5%;χ^(2)=26.73,P<0.01).Contact with cats,consumption of raw vegetables,exposure to animal feces,history of chemotherapy,and history of anti-tumor targeted therapy were significantly associated with postoperative TOX infection in liver transplant recipients(χ^(2)=4.23-30.10,P<0.05).Conclusion The postoperative TOX infection rate in liver transplant recipients is significantly higher than that in healthy adults in Qingdao,Shandong Province,which may be related to the decline in immunity and some living habits of transplant recipients.The level of TOX antibodies in the serum of liver transplant patients should be monitored regularly in clinical practice and the publicity and education should be strengthened in order to prevent and control infection with TOX after transplantation.

关 键 词：肝移植 弓形虫病 免疫球蛋白M 免疫球蛋白G 危险因素 

分 类 号：R531.8[医药卫生—内科学] R657.3[医药卫生—临床医学]