中国肾移植受者结核病临床诊疗指南(2023版)  

Guideline for clinical diagnosis and treatment of tuberculosis in kidney transplant recipients in China(2023 edition)

作　　者：中华医学会器官移植学分会 王强[2] 余磊 Branch of Organ Transplantation of Chinese Medical Association;Wang Qiang(不详;Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]不详 [2]北京大学人民医院,北京100044

出　　处：《器官移植》2024年第3期323-332,共10页Organ Transplantation

基　　金：国家自然科学基金项目(82070765);医学免疫学国家重点实验室开放课题(NKMI2020K05);蛋白质组学国家重点实验室开放课题(SKLPO202009);北京大学人民医院研究与发展基金(2147000985)。

摘　　要：本指南旨在为肾移植受者结核病的临床管理提供全面而实用的指导。首先,概述了肾移植受者结核病的特殊性,强调了其高发生率及临床表现的多样性。为了更好地理解患者的病情,建议在移植前进行结核病相关的评估,并注意移植术后对结核病的监测。在诊断方面,详细介绍了目前常用的结核病诊断方法,并提供了在肾移植受者中的适用性评估。在确诊后,讨论了在免疫抑制药应用的背景下,如何平衡结核病治疗和排斥反应的策略,并关注了潜在的药物相互作用。预防方面,强调了在肾移植前对结核病的筛查。本指南旨在提高医务人员对肾移植受者结核病管理的认知,促进更有效的临床实践,提高受者的生活质量。This guideline aims to provide comprehensive and practical guidance for clinical management of tuberculosis in kidney transplant recipients.First,it summarizes the particularity of tuberculosis in kidney transplant recipients,and highlights the high incidence and diverse clinical manifestations.To better understand the patients'conditions,relevant assessment of tuberculosis is recommended before kidney transplantation.Extensive attention should be paid to the monitoring of tuberculosis after kidney transplantation.Regarding the diagnosis,the guideline explicitly introduces common diagnostic approaches for tuberculosis,and evaluates the applicability in kidney transplant recipients.After the diagnosis is confirmed,it discusses how to balance the treatment and rejection of tuberculosis under the background of immunosuppressants,and focuses upon the potential drug interaction.In terms of prevention,it emphasizes the screening of tuberculosis prior to kidney transplantation.This guideline is designed to deepen the understanding of medical staff for tuberculosis management in kidney transplant recipients,promote more effective clinical practice and improve the quality of life of the recipients.

关 键 词：肾移植 结核病 结核分枝杆菌 结核菌素皮肤试验 潜伏感染 活动性结核病 Γ-干扰素释放试验 免疫抑制药 

分 类 号：R617[医药卫生—外科学] R52[医药卫生—临床医学]