肾移植术后口服伐昔洛韦预防巨细胞病毒性肺炎的观察

目的探讨口服伐昔洛韦（valaciclovir）预防肾移植术后巨细胞病毒（CMV）性肺炎的有效性和安全性。方法前瞻性研究121例肾移植的临床资料，其中供、受者血清CMV-IgG均为阳性（D＋R＋组）肾移植63例，供者血清CMV-IgG阳性、受者血清CMV-IgG阴性（D＋R-组）肾移植58例。上述两组受者随机再分为预防组和对照组，预防组口服伐昔洛韦，对照组不给予抗病毒药物。观察肾移植术后1年内CMV性肺炎的发生率。结果预防组的受者对口服伐昔洛韦有良好的耐受性。预防组CMV性肺炎发生率为8．06％，对照组为22．03％，两组比较，差异有统计学意义（P〈0．05）。结论对供者血清CMV-IgG阳性、受者血清CMV-IgG阴性或供、受者血清CMV-IgG均为阳性的肾移植，受者预防性口服伐昔洛韦可以安全有效地降低术后CMV性肺炎的发生率。

Oral valaciclovir for cytomegalovirus pneumonia prophylaxis in renal transplant recipients

Objective To analyze the efficacy and safety of oral valaciclovir in prevention of cytomegalovirus(CMV) pneumonia after renal transplantation.Methods The clinical data of 121 patients receiving first cadaveric renal transplantation were prospectively analyzed.In 63((52.1%)) cases of renal transplantation,both donors and recipients were positive for CMVIgG(D+R+),while in 58 cases,donors were positive for serum CMV-IgG and recipients negative for CMVIgG(D+R-).All the patients were randomized to two groups: prophylaxis group and control group.The incidence of CMV pneumonia within 1 year post-transplantation was prospectively analyzed.Results Valaciclovir therapy was well tolerated in patients who received oral Valaciclovir prophylaxis.The incidence of CMV pneumonia in the patients who received prophylaxis therapy was(8.06%), and(22.03%) in control group(P<(0.05)).For D+R-patients,the incidence of CMV pneumonia in prophylaxis group was(6.67%),and(28.57%) in control group(P<(0.05)).Conclusion For the patients of D+R-or D+R+,oral valaciclovir prophylaxis is an effective measurement to decrease the incidence of CMV pneumonia after renal transplantation.