肾移植术后并发结核的诊治(附10例报告)

（１）目的 探讨肾移植病人并发结核的临床特点及诊治方法。（２）方法 对１０例肾移植病人并发结核的发病特点、诊断方法及治疗效果进行了回顾分析。术后病人常规进行硫唑嘌呤（Ａｚａ）、泼尼松（Ｐｒｅｄ）二联，或环孢霉素Ａ（ＣｓＡ）、Ａｚａ、Ｐｒｅｄ三联免疫抑制治疗；１０例病人均根据临床表现，结合Ｘ线检查、ＰＣＲ扩增结核杆菌ＤＮＡ及组织学检查确诊为结核菌感染。给予异烟肼、利福平、乙胺丁醇，或异烟肼、利福平、

DIAGNOSIS AND TREATMENT OF POSTOPERATIVE TUBERCULOSIS IN THE RENAL RECIPIENTS: REPORT OF 10 CAS-ES

Objective\ To investigate the clinical features and methods of diagnosis and treatment of postoperative tuberculosis in the renal recipients.\ Methods\ The features of occurrence, methods of diagnosis and results of treatment of postoperative tuberculosis in 10 renal recipients were retrospectively analyzed. The patients underwent renal transplantation were routinely treated with following regiment: azathioprine prednisolone or cyclosporin azathioprine prednisolone. The diagnosis of tuberculosis infection in 10 patients was confirmed based upon the clinical manifestations and the findings of X ray, PCR and histology. Treatment regiment in the renal recipients with confirmed tubreculosis infection included one of the following drugs combination: isoniazid rifampicin ethambutol or isoniazid rifampicin pyrazinamide.\ Results\ Seven patients recovered and three died.\ Conclusion\ It was difficult to diagnose postoperative tuberculosis of renal recipients in the early stage since the onset symptoms were not so obvious and typical. Repeated examinations of chest X ray and PCR are helpful in diagnosis of tuberculosis.