心脏移植术后急性排斥反应1例临床监测经验总结

目的 总结心脏移植术后急性排斥反应的临床监测体会.方法 回顾性分析1例心脏移植术后死于急性排斥反应患者的临床资料,分析术后排斥反应监测情况.结果 患者术后半年随访行心内膜心肌活组织检查(活检),结果为Ⅱ级急性排斥反应,经治疗好转出院.术后3年因上呼吸道感染出现气促再次入院,心内膜心肌活检结果为0~ⅠA级改变,病情恶化,...

Experience of acute rejection monitoring after heart transplantation:a case report

Objective To summarize the experience of acute rejection clinical monitoring after heart transplantation.Methods Clinical data of a patient died of acute rejection after heart transplantation were retrospectively analyzed.Results The patient developed grade Ⅱ acute rejection at sixth month after heart transplantation.The acute rejection was confirmed by endomyocardial biopsy and the patient recovered after treatment.Three years after transplantation,the patient was re-hospitalized for anhelation after upper respiratory tract infection.The endomyocardial biopsy demonstrated grade 0-ⅠA change.His health was deteriorating rapidly and he died finally.The autopsy results indicated the existence of grade Ⅳ acute rejection.Conclusions Endomyocardial biopsy is an important method in monitoring cardiac acute rejection,but with some effect.When the biopsy result is inconsistent with clinical manifestation and laboratory testing,other monitoring methods should be effectively taken to decrease the rate of missed diagnosis and to increase the survival rate of patients.