丙型肝炎病毒感染对肾移植术后影响的临床研究

目的 探讨丙型肝炎病毒(Hepatitis C virus,HCV)感染对肾移植术后的影响。方法 比较86名HCV感染和86名非HCV感染病人肾移植术后1,3,5年人/肾存活率和急、慢性排斥反应的发生率,并对死亡病例的原因进行分析。结果 两组病人在肾移植术后不同时间人/肾的存活率分别为:术后1年(94.2%/90.7%和96.8%/96.0%);术后3年(88.4%/79.1%和90.7%/87.2%);术后5年(74.4%/73.3%和87.2%/81.4%)。两组急性排斥反应发生率为31.3%和21.2%,慢性排斥反应发生率为12.5%和6.5%。其中HCV感染组5年人存活率低于非HCV感染组(P<0.05),而其他各项结果无统计学差异(P>0.05)。肝病为感染组的首位死亡原因(36.4%)。结论 HCV感染对肾移植受者术后长期存活存在负面影响,HCV感染应作为肾移植手术的相对禁忌证。     

肾移植术后病毒感染及防治

目的：探讨肾移植术后常见病毒感染的发病机理及防治措施。方法：调整免疫抑制剂及运用嘌呤核苷酸类衍生物抗病毒药万乃洛韦或阿昔洛韦预防和治疗病毒感染。结果：本组15例病毒感染，痊愈13例，1例死于重症肝,1例死于混合感染。结论：合理应用免疫抑制剂及抗病毒药是预防和治疗肾移植术后病毒感染的有效方法。     

肾移植术后丙型肝炎11例报道

目的分析肾移植后丙型肝炎的发病原因及其临床特点。方法对1994～1996年肾移植患者64例进行随访。结果发现肾移植后丙型肝炎11例,其中4例HCV－RNA（＋）;血总胆红素全部升高,达正常值的2．38倍。结论肾移植后丙型肝炎以慢性活动性肝炎伴黄疸为主,但可以表现为隐性感染或暴发型。     

12例肾移植术后巨细胞病毒感染的CT分析

目的 分析肾移植术后巨细胞病毒(CMV)的CT表现,旨在提高对肾移植术后CMV感染的CT诊断水平.方法 对本院肾移植术后CMV肺炎12例CT扫描检查进行回顾性分析.结果 CT表现为除1例仅表现为纹理增强;余下11例以两肺弥漫分布磨玻璃影为主;伴发弥漫微小结节影2例;斑片影7例;小叶间隔增厚3例.结论 肾移植术后肺巨细胞病毒感染最常见CT表现为双肺弥漫性分布的磨玻璃影,常伴有小叶间隔增厚、小结节影、实变影等表现,肾移植术后CT出现上述征象,应首先考虑巨细胞病毒感染.     

肾移植术后疱疹病毒感染的治疗

肾移植术后疱疹病毒感染的治疗解放军第４５２医院（６１００６１）许亚宏陈源根周志成马小平顾新伟汤峰张新春廉吉吉临床资料一、一般资料：自１９９１年７月至１９９６年１２月我院共行同种异体肾移植４２例，其中７例在术后一个半月内发生有临床症状的疱疹病毒感染，发...     

膦甲酸钠对肾移植术后巨细胞病毒感染的治疗

器官移植术后巨细胞病毒 (CMV)感染的治疗是临床颇感棘手的难题 ,严重影响器官移植的效果与患者的存活时间。本文介绍我院肾移植中心在诊断与使用膦甲酸钠 (PFA)治疗此病时所积累的经验与体会。1　材料和方法1.1　 CMV感染诊断标准1.1.1　临床表现　间质性肺炎 ,全血细胞减少 ,伴有或不伴有发热、脑炎、肝炎、胃肠炎、急性视网膜炎、恶心或关节痛等。临床经抗细菌、真菌、支原体等治疗无效。1.1.2　实验室检查　使用美国美达生物高科技 (上海 )有限公司提供的 CMV Ig M,Ig G检测试剂盒。采用 EL ISA一步法测定血清或血浆标本中的 C…     

高龄患者肾移植的临床研究

目的：探讨高龄患者肾移植的临床效果。方法：对55例年龄大于50岁肾移植患者及同期95例年龄小于35岁肾移植患者的临床资料进行回顾性分析并进行比较。结果：高龄组肾移植1、3年人／肾存活率（85．5％／81＝7％和76．4％／72．7％）与青年组无显著差异,高龄组心,脑血管疾病发生率高于青年组,而急性排斥发生率少于青年组。结论：针对高龄患者的特点,积极预防心,脑血管并发症的发生,高龄患者肾移植可以取得同青年人一样的疗效。     

丙型肝炎患者肾移植术后霉酚酸酯的应用

目的 探讨丙型肝炎患者肾移植术后霉酚酸酯（MMF）的合理应用。方法 随访49例丙型肝炎肾移植患者，术前肝功能正常．术后给予强的松（prednisone Pred）、MMF、环孢素）或普乐可复三联免疫抑制治疗，将术后肝功能异常的患者分为持续服药（服药组）、减少或停用MMF（减停组）两组，均给予保肝治疗，观察各组治疗所需的天数。结果 49例患者中19例患者出现肝功能异常．服药组8例、减停组11例，在相同治疗方案下，两组肝功能异常至好转及肝功能好转至正常所需的治疗天数均有显著差异（P〈0．05）。结论 丙型肝炎患者肾移植术后出现肝功能异常应减少或停用MMF，并及时给予保肝治疗。使患者肝功能尽快好转。     

95例重症肝炎中丙型肝炎病毒感染的临床研究

９５例重症肝炎中丙型肝炎病毒感染的临床研究宁夏医学院附院传染病科（７５０００４）李葳杨岩孙花芬丙型肝炎病毒（以下简称ＨＣＶ）感染与慢性肝炎、肝硬化和肝癌的关系日趋明确，为了探讨ＨＣＶ感染与重症肝炎的关系，我们对９５例重症肝炎患者进行了血清抗—ＨＣＶ检...     

肾移植术后红细胞增多症的临床研究

肾移植术后红细胞增多症的临床研究孙淑清扈昕虹王强高占军王冰峰邓宏刘建平（中国人民解放军第４６５医院外四科１３２０１１）我院自１９８７年１０月～１９９５年１２月共行同种异体肾移植８６例，其中发生肾移植术后红细胞增多症（ＰＴＥ）８例，发生率为９．３％，现...     

Hepatitis C virus infection in hemodialysis patients]

To study whether HCV infection is present in dialysis patients and the status of antibody responses to HCV viremia, 16 patients undergoing hemodialysis were assayed for anti-HCV by ELISA and RIBA. A high incidence of anti-HCV (13/16) was found. All the 16 patients were studied for HCV viremia by 'nested' PCR and 10 were HCV RNA positive. Altogether 14 were anti-HCV and/or HCV RNA positive, which indicates that the incidence of HCV infection is high in hemodialysis patients, at least in some units. Cloning, sequencing of the PCR products showed high homology among isolates, with 91% homology to that of Japanese strains. It is important to study anti-HCV/HCV RNA in dialysis patients.     

丙型肝炎病毒感染与肝细胞癌

目的;了解丙型肝炎病毒（ＨＣＶ）感染与肝细胞癌（ＨＣＣ）的关系。方法：采用ＥＬＩＳＡ和聚合酶链反应（ＰＣＲ）对皖北地区８７例肝细胞癌、８０例肝硬化和１００名健康对照进行乙肝型肝炎病毒（ＨＢＶ）、ＨＣＶ血甭标志和ＨＢＶ－ＤＮＡ、ＨＣＶ－ＲＮＡ检测。结果;皖北地区肝癌和肝硬化的发生,除与ＨＢＶ感染密切相关外,与ＨＣＶ感染亦密切相关。     

Hepatitis C virus genotypes: clinical relevance and therapeutic implications

The incidence of hepatitis C virus (HCV) -related hepatocellular carcinoma (HCC) has been increasing in several countries including Taiwan. There are six main genotypes, each of which contains closely related subtypes. Molecular epidemiological studies have shown marked differences in the genotype distribution by geographical region and between patient groups. HCV genotype 1 may play a role in the development of HCC, although some studies have argued against this. A sustained virological response secondary to interferon monotherapy or interferon/ribavirin combination therapy may reduce the risk of HCC and improve survival in chronic hepatitis C patients. The HCV genotypes are associated with therapeutic response. Rapid virological response is also a predictor of therapeutic response. Although viral characteristics have consistently been shown to be important predictors of treatment response, identification of additional host immune and genetic factors involved in determining the outcome of antiviral therapy is necessary. Newly developed bio-techniques (microarray, proteomes, bioinformatics), drugs, and treatment strategies may elucidate the pathogenesis and improve the therapeutic response in HCV infection.     

透析患者的丙型肝炎感染

目的观察血液透析患者的丙型肝炎感染情况。方法用酶联免疫吸附试验检测175例血液透析患者血清中抗丙型肝炎病毒（抗HCV）。结果175例血液透析患者中,抗HCV阳性率透析〈2年为6.20％,透析〉2年为47．83％。结论随着透析年限延长,丙型肝炎感染概率加大。     

肾移植术后肺部感染的诊断与治疗

目的探讨肾移植术后肺部感染的诊断与治疗。方法对21例肾移植术后肺部感染的病原体及其致病特点、诊断、治疗等临床资料进行分析。结果21例肾移植术后肺部感染患者中单纯细菌感染6例(28.57%),真菌感染2例(9.52%),巨细胞病毒(CMV)感染2例(9.52%),结核菌感染1例(4.76%),混合感染9例(42.86%),病原体不清1例。2例予以呼吸机辅助治疗。19例治愈,治愈率为90.48%,2例直接死于肺部感染。结论肾移植术后肺部感染患者应早期行病原学诊断,积极有效抗感染,及时调整免疫抑制方案。     

丙型肝炎病毒的垂直传播研究

目的 探讨丙型肝炎病毒(HCV)的垂直传播机制。方法 选择6对抗-HCV与HCVRNA均阳性的母亲与胎儿，2对父亲抗-HCV与HCVRNA阳性、母亲阴性的胎儿为研究对象，检测父、母亲与子代HCV的感染标志，同时比较两代问所携HCV的基因型别与HCVC／E1区的序列同源性。结果 6对母亲与胎儿HCVRNA阳性，基因型均一致，其中5对基因型别属Ⅱ型，1对属Ⅲ型。母亲与子代间所携HCVC／E1区的序列同源性极高，与其他母亲间、胎儿间的HCV同源性显著差异。2对父亲HCVRNA阳性其胎儿未检测到HCVRNA。结论 母亲与子代间存在出生前期的HCV的垂直传播。     

Hepatitis C virus infection: Its role in chronic liver diseases

Summary In order to find out the infectious rate of hepatitis C viris (HCV) among chronic liver diseases, we investigated antibodies against hepatitis C virus and HCVRNA by method of ELISA, R1BA and RT-PCR in 410 patients with chronic liver disease. The prevalence of HCV infection was found to be 4%. Whereas the positive rate of HBsAg and HBV-DNA of these cases was 69% and 58%, respectively. There is no statistical significance between HCV infectious rate of patients with positive and negative HBsAg. The relative low infectious rate of HCV infection among chronic hepatic diseases indicates that HBV infection plays a more important role in causing chronic hepatitis than that of HCV. Thus, special emphasis should be paid to the preventive and therapeutic measures against hepatitis B in China.     

Hepatitis C virus infection and coinfection with human immunodeficiency virus: challenges and advancements in management

Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) both emerged in the second half of the 20th century, and chronic infection with these agents is among the greatest challenges facing health care in the United States and worldwide. Despite tremendous advances in treatment and management of HIV and HCV, individuals with HIV/HCV coinfection experience a more complicated disease course and treatment. Recognition of the important role that host factors, such as IL28B genotype, have in response to HCV therapy and the emergence of new effective therapies for HCV are actively reshaping the standard of care. These advances may translate into more effective treatment and management of patients with chronic HCV and HIV coinfection in the years ahead.