肾脏移植后巨细胞病毒感染24例

回顾性总结分析北京友谊医院施行肾脏移植395例患者移植后巨细胞病毒感染的临床特点及其防治措施。395例患者移植后3个月内常规接受预防巨细胞病毒感染及卡氏肺囊虫感染治疗中，24例移植后出现巨细胞病毒感染，发现病毒血症时应用更昔洛韦/膦甲酸钠治疗。重症感染特如重症肺部感染时，立即减少甚至停用免疫抑制药物或逐步增加、减少免疫抑制药物的剂量，24例患者治疗效果满意。分析结果认为，移植前对受者进行相关危险性评估、移植后早期采取预防性治疗、加强临床流行病学检测，早诊断，采取个体化免疫抑制药物用药方案，能有效预防和对抗巨细胞病毒感染，在预防移植肾急性排斥反应和保护移植肾功能方面会发挥较好的作用。

Cytomegalovirus infections after renal transplantation in 24 cases

The article retrospectively analyzes the clinical characteristics and prevention measures of cytomegalovirus (CMV) infections after renal transplantation in 395 patients from Beijing Friendship Hospital Affiliated to Capital Medical University. All patients received preventive treatment of CMV infections and pneumocystis carinii infections in three months after renal transplantation. CMV infections occurred in 24 of 395 patients. The patients with viremia were treated with Ganciclovir or foscarnet sodium. The patients with severe infections (eg. severe pulmonary infections) should be treated with decrease dosage of immunosuppressive drugs, even stop administration. Then the immunosuppressive drugs were adopted again if the infections were controlled. Twenty-four patients obtained the satisfied efficacy. The results suggested that evaluation of the risk for CMV infections before transplantation, preventive treatment in early time after transplantation, measurement of clinical epidemiology, early diagnosis, and individual medication scheme of immunosuppressive drugs for patients should be effective to prevent and against CMV infections. And they also played an important role in preventing acute allograft rejection after renal transplantation and protecting the function of the graft.