实用器官移植电子杂志 ›› 2018, Vol. 6 ›› Issue (3): 187-191.DOI: 10.3969/j.issn.2095-5332.2018.03.006

• 论著 • 上一篇    下一篇

肝移植术后中远期巨细胞病毒的感染情况及诊治

黄云帆 1,刘大平 2,陈虹 3,王旭 3,范铁艳 3   

  • 出版日期:2018-05-20 发布日期:2021-06-24

The epidemiological and clinical research of mid-long-term cytomegalovirus infection after liver transplantation

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

摘要:

目的 探讨肝移植术后中远期巨细胞病毒(CMV)感染的发生情况、流行病学特点、临床 表现及诊治的特殊性。方法 回顾性分析 2005 年 1 月— 2012 年 4 月期间武警总医院移植研究所进行肝移 植术患者术后中远期发生 CMV 的感染情况。血清学检测 CMV 免疫球蛋白 M(CMV-IgM)及免疫球蛋白 G (CMV-IgG),抗原检测 CMV 抗原(CMV-pp65),荧光定量 PCR 技术检测 CMV 脱氧核糖核酸(CMV-DNA)。 结果 期间共行肝移植术 736 例,术后中远期感染发生 163 例,感染的发生率为 22.1% ;其中 CMV 感染 14 例,感染的发生率为 1.9%。CMV 感染多发生于术后 1 ~ 86 个月,平均时间为 7 个月。结论 肝移植术 后中远期感染的发生率较早期明显降低,而 CMV 是肝移植术后一个较为常见的病毒感染,肝移植术后患者 发生 CMV 感染的时间可能会随着预防方案的普遍运用而延后。肝移植术后中远期巨细胞病毒感染是一个不 容忽视的问题,需提高认识和诊断能力。

Abstract:

Objective To investigate the incidence,epidemiological characteristics,the clinical features and the treatment of mid-long-term cytomegalovirus(CMV)infection after liver transplantation. Methods The patients with mid-long-term cytomegalovirus infection after liver transplantation in the Armed Police General Hospital between January 2005 and April 2012 were analyzed retrospectively. CMV immunoglobulin M(CMV-IgM) and immunoglobulin G(CMV-IgG)were detected by serological method. CMV antigen(CMV-pp65)was detected by immulogical stain,and CMV-DNA was detected by fluorescent quantitative PCR. Results A total number of 736 cases of liver transplantation were performed,and 163 cases of postoperative infection occurred. The overall incidence was 22.1%. Among them,there were 14 cases of CMV infection the incidence of which was 1.9%. CMV infection occurred between 1-86 month after the operation,and the average time of CMV infection was 7 months. Conclusion Mid-long-term CMV infection after liver transplantation is a problem that cannot be ignored,and the abilities of recognition and diagnosis should be improved.