肾移植患者发生人微小病毒B19感染临床诊断治疗经验  

Clinical experience in diagnosis and treatment of human parvovirus B19 infection in kidney transplant patients

作　　者：宋醒 李昕 杨宏伟 何龙 杜国盛 Song Xing;Li xin;Yang Hongwei;He Long;Du Guosheng(Department of Organ Transplantation Center,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院器官移植中心,沈阳110016

出　　处：《中国临床实用医学》2024年第6期9-12,共4页China Clinical Practical Medicine

基　　金：辽宁省科学技术计划项目(2021JH2/10300089)。

摘　　要：目的探究肾移植术后人微小病毒B19(HPV B19)感染的临床特点及治疗方法。方法本研究为病例系列分析, 选取2023年1月至2024年7月北部战区总医院器官移植中心收治的6例肾移植后HPV B19感染患者, 男3例, 女3例, 年龄(36.5±5.6)岁, 年龄范围为27~44岁。血清标本采用实时荧光定量逆转录聚合酶链反应测定HPV B19感染。结果 6例HPV B19感染患者均表现出贫血相关症状, 其中有2例患者明确诊断为再生障碍性贫血。4例患者接受了静脉注射免疫球蛋白(IVIG)治疗, 其中1例患者接受了2个疗程的IVIG治疗, 同期更换他克莫司为环孢素。1例患者在早期发现HPV B19(+)后, 减少免疫抑制剂剂量, 临床症状缓解。结论肾移植术后出现不明原因的严重贫血, 应高度怀疑HPV B19感染可能。IVIG治疗可有效改善贫血症状, 可重复行IVIG疗程并伴免疫抑制剂的转换。ObjectiveTo investigate the clinical characteristics and treatment of human parvovirus B19(HPV B19)infection after kidney transplantation.MethodsThis study was a case-series analysis,a total of 6 patients with HPV B19 infection after kidney transplantation admitted to the Organ Transplantation Center of General Hospital of Northern Theater Command from January 2023 to July 2024 were selected,including 3 males and 3 females.Mean ages of patients were(36.5±5.6)years old,range 27 to 44 years old.HPV B19 infection was detected by quantitative real-time polymerase chain reaction in serum samples.ResultsAll the 6 patients with HPV B19 infection showed anemia-related symptoms,of which 2 patients were diagnosed as aplastic anemia.A total of 4 patients received intravenous immunoglobulin(IVIG)therapy,and one patient of them received IVIG therapy for two courses,with tacrolimus replaced by cyclosporine.In one patient,after early detection of HPV B19(+),the dose of immunosuppressant was reduced and clinical symptoms were relieved.ConclusionsThe possibility of HPV B19 infection should be highly suspected for the occurrence of unexplained severe anemia after renal transplantation.The treatment of IVIG can effectively improve the symptoms of anemia,and the IVIG course can be repeated with immunosuppressive conversion.

关 键 词：肾移植 微小病毒B19 他克莫司 静脉注射免疫球蛋白 感染 

分 类 号：R73[医药卫生—肿瘤]