肝移植病人术后巨细胞病毒感染的预防和治疗

目的 分析肝移植术后病人巨细胞病毒(CMV)感染的诊断、预防和治疗。方法 采用回顾性分析的方法，分析我科2000年8月至2002年1月期间进行的同种异体原位肝移植病例。结果 共进行同种异体原位肝移植36例。术后8例发生巨细胞病毒感染，其中2例出现腹泻，发热2例，1例为黄疸，4例无明显症状。在CMV感染的病人中，检测到CMV—IgM( )或(和)CMV-DNA( )，其中CMV—IgM( )5例，CMV-DNA( )6例。病人经更昔洛韦治疗后血清CMV-DNA变为阴性。全部治愈。结论 对病人CMV—IgM和CMV—DNA(FQ-PCR方法)联合检测应用能够对CMV感染病人作出诊断并且指导治疗。更昔洛韦能够有效的治疗CMV感染。

Prevention and treatment of cytomegalovirus infection after liver transplantation

Objective To analyze diagnosis, treatment and prevention of cytomegalovirus (CMV) infection after liver transplantation. Methods The clinical data of 36 patients receiving orthotopic liver transplantation (OLT) in our hospital from August 2000 to January 2002 were retrospectively analyzed. Results CMV infection occurred in 8 patients. Two of them presented with diarrhea, 2 with fever and 1 with jaundice. Four patients had no symptoms of CMV infection. Blood CMV-IgM positivity and/or CMV-DNA positivity was detected in all the patients with CMV infection. There were 5 patients of blood CMV-IgM positivity and 6 of CMV-DNA positivity. Blood CMV-DNA became negative by treatment with ganciclovir. Conclusions The detection of CMV-DNA and CMV-IgM was necessary for diagnosis and guiding treatment of CMV infection. Ganciclovir was effective for treatment of CMV infection.