肝移植术后巨细胞病毒性肺炎的治疗策略

探讨肝移植术后巨细胞病毒（cytomegalovirus，CMV）性肺炎的治疗方法。方法回顾分析我科2003年10月至2005年6月所行的451例肝移植病人的临床资料。发生CMV肺炎的共7例。采用更昔洛韦联合磷甲酸钠联合抗CMV，结合停用免疫抑制剂、加用大剂量丙种球蛋白和适量的胸腺肽等免疫增强剂的个体化免疫调节方案，同时采用广谱抗生素预防感染和其他对症支持等综合治疗方法。结果发生CMV感染共86例，感染率为19．1％。其中CMV肺炎7例，发生率为1．66％。治愈6例，治愈率为85．7％。结论采取联合抗病毒和个体化免疫调节等综合治疗措施效果确切。

Treatment of cytomegalovirus pneumonia after orthotopic liver transplantation

Objective To study the treatment of cytomegalovirus (CMV) pneumonia in recipients of orthotopic liver transplantation (OLT). Methods The clinical data of 451 patients receiving OLT in our hospital from October 2003 to June 2005 were retrospectively analyzed. Seven out of the 451 patients had CMV pneumonia after OLT. All the 7 patients were treated with ganciclovir and foscarnet and immunosuppressive drugs were withdrawn. Meanwhile, all of them received high-dose immunoglobulin, low-dose thymulin and broad-spectrum antibiotics. Results CMV infection occurred in 86 patients and the morbidity was 19.1%. Seven of them had CMV pneumonia. Six of the 7 patients were cured and the curative rate was 85. 7%. Conclusions The combination of antiviral treatment with individualized immunologic adjustment and comprehensive therapy is effective for treatment of CMV pneumonia.