肝移植术后巨细胞病毒肺炎的诊断和治疗

目的探讨肝移植术后巨细胞病毒（CMV）肺炎的诊断和治疗方法。方法回顾分析5例肝移植术后CMV肺炎病例。CMV肺炎的诊断主要根据临床表现、肺部x线检查和病原学检查。5例患者均接受以抗病毒和免疫调节为主的综合治疗。结果CMV肺炎的临床表现呈非特异性。其症状主要包括发热、咳嗽、呼吸困难、心率增快、疲乏、低氧血症和白细胞减少等。肺部x线检查显示问质性肺炎。患者血清中可检测到CMV抗原或抗体。4例治愈,1例死亡。治愈率为80％,死亡率为20％。结论肝移植术后CMV肺炎的临床表现呈非特异性,其诊断主要根据临床表现、肺部X线检查及病原学检查,采取以抗病毒和免疫调节为主的综合治疗有较好疗效。

Diagnosis and treatment of cytomegalovirus pneumonia after liver transplantation

Objectives To investigate the diagnosis and treatment of cytomegalovirus(CMV) pneumonia after liver transplantation.Methods Five cases of CMV pneumonia after liver transplantation were analyzed retrospectively.CMV pneumonia was diagnosed according to its clinical manifestation,chest X-ray,and etiologic test.All 5 patients received comprehensive therapy based on anti-virus treatment and immunologic adjustment.Results The clinical manifestation of CMV pneumonia after liver transplantation was nonspecific.Its main symptoms included fever,cough,dyspnea,tachykardia, fatigue,hypoxemia and neutropenia.The chest X-ray showed interstitial pneumonia.Sera CMV antigens or antibodies could be detected in the patients.Four patients were cured and 1 patient died.Conclusions The clinical manifestation of CMV pneumonia was nonspecific.CMV pneumonia could be diagnosed according to its manifestations,chest X-ray and etiologic test.The comprehensive therapy based on anti-virus treatment and immunologic adjustment was effective for the disease.