肾移植术后肺部感染患者免疫抑制剂的应用

目的:探讨肾移植术后肺部感染患者救治过程中免疫抑制剂的应用方案.方法:报告22例肺部感染的肾移植患者的临床资料.重症肺部感染13例,肺部感染早期或症状较轻的9例.前者立即停用所有免疫抑制剂,给予甲基泼尼松龙;后者减少或调整免疫移植剂用药方案等.13例检出病原菌,其中混合感染10例.结果:18例治愈,移植肾功能正常;死亡2例,放弃治疗2例.结论:对肾移植术后肺部感染及时停用或调整免疫抑制剂用量和组合方案,保护移植.肾的功能和及早确定病原菌等,均有利于提高其治愈率,减少死亡率.

Adjustment of immunosuppressive agents in renal transplantation recipientscomplicated with pulmonary infection

Objective:To explore the scheme of the immunosuppressive agents in renal transplantation patients complicated with pulmonary infection. Methods:The clinical data of 22 renal transplantation recipients complicated with pulmonary infection were retrospectively analyzed. There were 13 patients with severe pulmonary infection and 9 patients with moderate or earlier pulmonary infection. The immunosuppressant was ceased in the former group and lowered or revised in the later one. Pathogenic bacteria were detected in 13 cases, and 10 cases were mixed infection. Results:Eighteen cases were rescued successfully with normal graft function and 4 cases died. Conclusions:Pulmonary infection is a major complication of renal transplantation. Early diagnosis and determining the germ, in time treatment ,modulation of immunosuppressive agents and protection of the graft ,etc, can help to raise the cure rate and decrease the mortality.