中国肾脏移植术后耶氏肺孢子菌肺炎临床诊疗指南  

Guidelines for clinical diagnosis and treatment of Pneumocystis jirovecii pneumonia after kidney transplantation in China

作　　者：中华医学会器官移植学分会 王振[2] 史晓峰[2] 郑建明[2] 冯钢[2] 赵杰[2] 宋文利[2] Branch of Organ Transplantation of Chinese Medical Association;Song Wenli(不详;Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]不详 [2]天津市第一中心医院,天津300192

出　　处：《器官移植》2024年第5期726-736,共11页Organ Transplantation

基　　金：天津市科技计划项目(21JCYBJC01010)。

摘　　要：肾脏移植术后受者因使用免疫抑制药长期处于免疫抑制状态,是耶氏肺孢子菌肺炎(PJP)感染的高危人群。肾脏移植术后6个月内和强化抗排斥反应治疗后是PJP发生的高危期,发热、干咳、进行性呼吸困难和低氧血症是肾脏移植术后PJP常见的临床表现。甲氧苄啶-磺胺甲噁唑(TMP-SMX)可有效预防和治疗PJP,显著降低PJP的发生率和患者病死率。为规范肾脏移植术后PJP的诊断、治疗和预防,中华医学会器官移植学分会组织国内相关专家,从临床关注问题出发,制订《中国肾脏移植术后耶氏肺孢子菌肺炎临床诊疗指南》,指导肾脏移植术后PJP的预防和临床综合治疗。After kidney transplantation,the recipients have been under long-term immunosuppression due to the use of immunosuppressive drugs,and they are high-risk population of Pneumocystis jirovecii pneumonia(PJP).The risk of PJP is the highest within 6 months after kidney transplantation and after intensified anti-rejection therapy.Fever,dry cough,progressive dyspnea and hypoxemia are common clinical manifestations of PJP after kidney transplantation.Trimethoprim-sulfamethoxazole(TMP-SMX)can effectively prevent and treat PJP,and significantly reduce the incidence rate and fatality of PJP.To standardize the diagnosis,treatment and prevention of PJP after kidney transplantation,Branch of Organ Transplantation of Chinese Medical Association organized relevant Chinese experts to formulate the"Guidelines for Clinical Diagnosis and Treatment of Pneumocystis Jirovecii Pneumonia After Kidney Transplantation in China"based on clinical concerns,aiming to provide guidance for the prevention and comprehensive clinical treatment of PJP after kidney transplantation.

关 键 词：肾脏移植 耶氏肺孢子菌 耶氏肺孢子菌肺炎 实体器官移植 免疫抑制 甲氧苄啶 磺胺甲噁唑 糖皮质激素 

分 类 号：R617[医药卫生—外科学] R563.1[医药卫生—临床医学]