肝移植术后侵袭性曲霉菌病的诊疗进展  

Progress in diagnosis and treatment of invasive aspergillosis after liver transplantation

作　　者：潘胜辉 孙江波 徐剑 PAN Sheng-hui;SUN Jiang-bo;XU Jian(Department of Organ Transplantation,the Second Affiliated Hospital of Hainan Medical University,Haikou 570105,China)

机构地区：[1]海南医学院第二附属医院器官移植科,海南海口570105

出　　处：《海南医学院学报》2023年第15期1194-1200,共7页Journal of Hainan Medical University

基　　金：海南省重大科技计划项目(ZDK2019009)。

摘　　要：侵袭性曲霉菌病是一种机会性真菌感染疾病,肝移植术后侵袭性曲霉菌病的危险因素在不断地增加,严重影响患者的生存质量。侵袭性曲霉菌无特异性临床表现,最多发生于肺部。侵袭性曲霉菌病的诊断方法在不断地更新,包括血清学检查、聚合酶链式反应(PCR)、新一代测序、基质辅助激光解吸电离飞行时间质谱、曲霉菌半乳甘露聚糖侧流试验以及一些正在研究的新的标志物,使侵袭性曲霉菌感染的诊断更加明确。伏立康唑是治疗及预防侵袭性曲霉菌病的首选药物,随着越来越多耐药菌株的出现,免疫治疗可能会成为辅助治疗或单独治疗侵袭性曲霉菌的方案。本文通过总结肝移植术后侵袭性曲霉菌病的诊疗进展,希望能为临床实践提供参考。Invasive aspergillosis is an opportunistic fungal infection disease,and the risk factors of invasive aspergillosis af-ter liver transplantation are increasing,which seriously affects the quality of life of patients.Invasive Aspergillus has no specific clinical manifestations and occurs most frequently in the lungs.The diagnostic methods for invasive aspergillosis are continuously updated,including serological tests,polymerase chain reaction,next-generation sequencing,Matrix-assisted laser desorption ion-ization time-of-flight mass spectrometry,Aspergillus glactomannan lateral flow test,and some new markers under study have made the diagnosis of invasive aspergillosis infection more definitive.Voriconazole is the drug of choice for the treatment and pre-vention of invasive aspergillosis,and immunotherapy may become an adjuvant therapy or monotherapy for invasive aspergillosis with the emergence of more and more resistant strains.This article summarizes the progress in the diagnosis and treatment of inva-sive aspergillosis after liver transplantation,in order to provide a reference for clinical practice.

关 键 词：肝移植 侵袭性曲霉菌病 半乳甘露聚糖检测 新一代测序 伏立康唑 

分 类 号：R519[医药卫生—内科学]