肾移植术后肺巨细胞病毒感染的影像学表现和治疗

目的探讨肾移植术后肺巨细胞病毒感染的胸部X线特点和治疗，以提高早期诊治效果。方法根据临床表现及实验室检测证实的4例肾移植术后巨细胞病毒感染的患者，动态观察其胸部X线表现。结果肺部巨细胞病毒感染，发生在术后10～12周，肺部X线变化快，主要表现为早期肺纹理增粗、增多、边缘模糊。随病变发展，肺内可见多发的渗出性病灶，单侧或双侧病变，重症可呈斑片状或大片状融合性模糊影。临床表现凶险，多出现呼吸窘迫。本组4例，经及时以更昔洛韦为主的抗病毒治疗后痊愈。结论胸部X线摄片是诊断肾移植术后巨细胞病毒感染的重要依据，对肾移植术后肺部CMV感染应及时应用以更昔洛韦为主的综合治疗。

X- ray Features and Treatment of the Patients with Cytomeglovirus Infection after Kidney Transplantation

Objective To study chest X - ray maanifestations of CMV infections after kidney transplantation and their treatments. Methods Dynamically observing chest X - ray features and transformation of 4 eases with CMV infection after kidney transplantations. The diagnoses of all cases were confirmed by clinical findings and laboratory examinatioins. Results Most CMV infections occulted within 10 -12 weeks after the operations. The chest X - ray manifestation changed quickly. Radiographs of patients showed only non - specific per bronchial and per vascular markings at earlier period. With the development of pathological changes, radiographgic abnormalities turned to patchy infiltrates in one or both lung fields. In some severs cases, radiographic findings ranged from patchg infiltrates to lobber consolidation. The 4 eases were all haled by comprehensive treatments, and their pathological changes were abosrbed. Conclusion Chest X - my is very helpful for making the diagnosis of CMV infection after kidney transplantation. Administration of Ganciclovir as treatment was effective.