实用器官移植电子杂志

实用器官移植电子杂志 ›› 2018, Vol. 6 ›› Issue (3): 183-186.DOI: 10.3969/j.issn.2095-5332.2018.03.005

• 论著 • 上一篇    下一篇

肝肾移植术后结核感染差异性分析

李俊 1，陈虹 2，范铁艳 2，邱爽 2，张庆 2，刘艳迪 1   

  • 出版日期:2018-05-20 发布日期:2021-06-24

Analysis of tuberculosis infection after liver and kidney transplantation

  • Online:2018-05-20 Published:2021-06-24

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摘要：

目的 探讨肝、肾移植术后结核感染患者的临床特点及治疗的差异。方法 回顾性分析 2002 年 4 月 - 2017 年 10 月，武警总医院器官移植科肝、肾移植术后并发结核感染的 43 例（肝 27 例、肾 16 例） 患者的临床资料，包括临床表现、实验室及影像学检查及治疗。结果 肝、肾移植术后出现结核感染率分 别为 1.73%、1.50%，两组结核感染率无统计学差异（P ＞ 0.05）；肝、肾移植组结核感染发病时间分别为 （18.25±28.12）月、（26.74±37.96）月，两组之间有统计学差异（P ＜ 0.05）；两组患者大多以发热为首要 表现或唯一表现，发热起病率分别为 70.37%、93.75%，两组之间无统计学差异（P ＞ 0.05）；两组患者均 以肺为主要感染部位，肺结核率分别为 51.85%、50.00%，两组之间无统计学差异（P ＞ 0.05）；两组患者 T-SPOT.TB 阳性率分别为 85.19%、81.25%，两组之间无统计学差异（P ＞ 0.05）；两组患者治疗有效率分 别为 81.48%、81.25%，病死率分别为 14.81%、12.50%，两组之间在治疗有效率及病死率方面均无统计学 差异（均 P ＞ 0.05）。结论 肝肾移植受者术后结核感染的发生率均较高，肝移植术后结核感染发病时间早 于肾移植术后患者，肝、肾移植术后并发结核感染患者免疫状态不同。两组患者经规范个体化治疗后大多 能取得良好效果，但容易合并器官功能衰竭等各种严重并发症致患者死亡。

Abstract:

Objective To summarize the differences in clinical features and treatment between the liver transplant recipients and kidney transplant recipients. Methods The data of Clinical manifestations, laboratory examination and imaging and treatment of 43 patients who were infected TB after liver or kidney transplantation from April 2002 to October 2017 were retrospectively analyzed. Results The rates of tuberculosis infection after liver and kidney transplantation were 1.73% and 1.50%, respectively. There was no statistical difference between the two groups（P ＞ 0.05）. The time of tuberculosis infection in liver and kidney transplantation group was（18.25± 28.12）months and（26.74±37.96）respectively. There was a statistically significant difference between the groups （P ＜ 0.05）. Fever was the primary or only manifestation in both groups, and the onset rates of fever were 70.37% and 93.75%, respectively, there was no statistical difference between the two groups（P ＞ 0.05）. The rates of pulmonary tuberculosis was 51.85% and 50.00% respectively in the two groups，and there was no statistical difference between the two groups（P ＞ 0.05）. The positive rates of T-SPOT.TB in the two groups were 85.19% and 81.25%, respectively. There was no statistical difference between the two groups（P ＞ 0.05）. The effective rates of two groups were 81.48% and 81.25%, respectively, and the mortality rates were 14.81% and 12.50%，respectively. There was no significant difference between the two groups in terms of treatment efficiency and mortality（all P ＞0.05）. Conclusion The incidence of tuberculosis infection in liver and kidney transplant recipients are both high. The incidence of tuberculosis infection after liver transplantation is earlier than that in renal transplant recipients. The immune status of tuberculosis patients after liver and kidney transplantation is different. Most patients in both groups achieved good results after standardized individualized treatment, but they were easily died of various serious complications such as organ failure.

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