肾脏移植术后巨细胞病毒感染并发急性胰腺炎的临床分析

目的 研究治疗肾脏移植术后巨细胞病毒感染并发急性胰腺炎的方法。方法 顾性分析了5例肾脏移植术后急性胰腺炎病人的临床资料。结果 移植术后急性胰腺炎的发病率为2.3%(5/217)。5例均合并活动性巨细胞病毒感染。其中3例同时伴有高脂血症,2例出现肝功能异常。5例患者中,治愈3例,死亡2例。在死亡的2例中,1例为巨细胞病毒性间质性肺炎呼吸衰竭合并出血坏死性胰腺炎,另1例为活动性人巨噬细胞病毒感染爆发性肝功能衰竭合并出血坏死性胰腺炎。结论 脏移植术后急性胰腺炎可以由多种因素诱发,但与巨细胞病毒感染的关系更为密切,早期诊断和治疗是降低死亡率的关键。

Cytomegalovirus infection accompanied with acute pancreatitis after kidney transplantation

Objective To explore the prevention and management of human cytomegalovirus (HCMV) infection accompanied with acute pancreatitis after kidney transplantation. Methods and Results A retrospective analysis of 5 patients with acute pancreatitis after kidney transplantation was conducted. The incidence of acute pancreatitis after kidney transplantation was 2.3% (5/217). All the 5 cases were complicated by active HCMV infection, 3 of which had hyperlipemia and 2 had liver dysfunction. Three cases were finally cured while the other 2 died, one of which was due to respiration failure arising from HCMV interstitial pneumonia accompanied with hemorrhagic necrotizing pancreatitis, and the other due to fulminating liver function failure because of active HCMV infection accompanied with hemorrhagic necrotizing pancreatitis. Conclusion Active HCMV infection is the most important factor responsible for acute pancreatitis, and early diagnosis and treatment are crucial to lower mortality rate.