肾移植术后BK病毒感染对肾功能影响的研究  

Effects of BK virus infection on renal function in patients after kidney transplantation

作　　者：路静 刘君君 张莹 LU Jing;LIU Jun-jun;ZHNG Ying(Department of Clinical Laboratory Medicine,the First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Shandong Jinan 250014)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)检验科,山东济南250014 [2]山东省第二人民医院(山东省耳鼻喉医院)检验科,山东济南250022

出　　处：《医学检验与临床》2024年第7期38-41,共4页Medical Laboratory Science and Clinics

摘　　要：目的:通过比较肾移植术后患者的BK病毒(BKV)DNA载量、肾功能指标的变化对患者感染情况进行分析,为临床提供诊疗依据。方法:将2023年1月一2024年3月期间在本院进行肾移植术的232例患者作为研究对象,通过实时荧光定量PCR法分别测定病毒尿症组和病毒血症组的DNA载量,采用全自动生化分析仪检测尿素氮(BUN)、血肌酐(SCr)、肾小球滤过率(GFR)、补体(C1)、四项肾功能指标。使用SPSS25.0软件分析病毒尿症组、病毒血症组BKV-DNA载量与阴性对照组的肾功能指标有无差异;分别分析尿液、血液中BKV-DNA载量与患者肾功能的相关性。结果:232例肾移植者中病毒尿症有93例,发生率为40.09%(93/232);病毒血症有42例,发生率为18.10%(42/232)。尿BKVDNA阳性组与尿BKVDNA阴性组相比,GFR、C1q水平降低,差异有统计学意义(P<0.05)。血BKVDNA阳性组与血BKVDNA阴性组相比,SCr、BUN水平升高,GFR、C1q水平降低,差异有统计学意义(P<0.05)。血BKVDNA载量与Scr、BUN水平呈正相关,与GFR、C1q水平呈负相关(P<0.05),结论:患者肾移植术后感染BK病毒会对其肾功能造成一定影响,临床应对术后患者制定定期复查计划,以便及时知晓患者是否感染BK病毒及肾功能是否异常,是否需要采取干预措施。Objective:To analyze the infection of patients by comparing the BK virus DNA load and the changes of renal function indexes in patients after receiving kidney transplantation,in order to establish a foundation for clinical diagnosis and treatment.Methods:The 232 patients who received a renal transplantation in our hospital between January 2023 and March 2024 were used as study subjects,and DNA load was determined by real-time fluorescence quantitative PCR in the viral uremia group and viremia group,respectively,and renal function indexes,such as urea nitrogen(BUN),blood creatinine(SCr),glomerular filtration rate(GFR),and complement(C1q),were detected by using a fully automated biochemistry analyzer.SPSS 25.0 software was used to analyze the difference of BKV-DNA load between viremia group,viremia group and negative control group.BKV-DNA load in urine and blood was analyzed correlation between volume and renal function of patients.Results:There were 93(40.09%)cases of viruria among 232 renal transplant recipients.The incidence of viremia was 18.10%(42/232).The levels of GFR and C1q in urine BKV DNA positive group were significantly lower than those in urine BKV DNA negative group(P<0.05).The levels of SCr and BUN in BKV DNA positive group were higher than those in BKV DNA negative group,and the levels ofGFR and C1q were lower than those in BKV DNA positive group,and both of the differences were statistically significant(P<0.05).Blood BKV DNA load was positively correlated with Scr and BUN levels,and negatively correlated with GFR and C1q levels(P<0.05).Conclusion:The infection of BK virus after kidney transplantation has a certain impact on the renal function of patients.It is necessary to formulate a regular review plan for postoperative patients in order to know in time whether the patient is infected with BK virus and whether the renal function is abnormal,and whether intervention measures are needed.

关 键 词：肾移植 BK病毒感染 DNA载量 肾功能 

分 类 号：R699.2[医药卫生—泌尿科学]