注射用喷昔洛韦在预防肾移植患者病毒感染中的应用

目的:评价注射用喷昔洛韦在预防肾移植患者病毒感染中的疗效与安全性。方法:对25例早期肾移植患者应用注射用喷昔洛韦预防病毒感染的临床资料进行回顾性分析。结果:实验组20例无任何感染的临床表现和实验室阳性结果,1例术后6周口周单纯疱疹感染,病毒感染发病率为4%(1/25);1例术后4周口腔溃疡并明确诊断为白念珠菌感染,1例术后2月肺部细菌感染,1例术后2月肺部曲霉菌感染,1例术后7周有右大腿局部皮肤刺痛,但未见明显水泡,3 d后自愈。对照组25例在术后6周和8周各出现1例带状疱疹,在院外用静脉阿昔洛韦治愈;术后85 d出现1例CMV肺炎,用缬更昔洛韦治愈,病毒感染发病率为12%(3/25);术后75 d和92 d各出现1例洛菲不动杆菌性肺炎和光滑念珠菌性肺炎,收住院后均治愈。用药前后,2组患者的免疫抑制剂浓度,肝肾功能,血常规化验等均平稳,前后比较在统计上相差不显著(P>0.05)。术后5周和3月分别查血CMV-DNA,实验组均为阴性;对照组在3月的复查中发现2例CMV-DNA弱阳性,故两组的病毒感染发生率相差显著,实验组为4%(1/25),对照组实际为20%(5/25),(P<0.05)。结论:注射用喷昔洛韦在预防肾移植患者病毒感染中是有效和安全的。

Intravenous penciclovir in the prevention of virus infection in kidney transplant recipients

OBJECTIVE To evaluate the efficacy and safety of intravenous penciclovir in the prevention of virus infection in kidney transplant recipients.METHODS The clinical data of 25 recipients using intravenous penciclovir were retrospectively analyzed.RESULTS In experimental group,there were no clinical manifestations of virus infection and laboratory positive results in 20 recipients.Infection complication occurred in 5 recipients,including: herpes simplex infection in labialoris(1),oral candida albicans infection(1),pneumonia(1),pulmonary aspergillosis(1),and suspected herpes zoster(1).In control group,herpes zoster occurred in 2,but both were reversed after treatment with intravenous acyclovir.CMV infection occurred in 1 and was reversed after treatment with Valganciclovir.Lafite Acinetobacter pneumonia and candida glabrata pneumonia occurred in 2 respectively,and both were cured after admission.During treatment,immunosuppressive drug concentration,liver and kidney function,blood routine examination were stable in all patients,and no significant change occurred after treatment.In experimental group,blood CMV DNA was negative 5 weeks and 3 months postoperatively.But in control group,it was weak positive in 2 cases 3 months postoperatively.The incidence of virus infection was significantly lower in experimental group(4%) than that in control group(20%).CONCLUSION Intravenous penciclovir is effective and safe to prevent virus infection in kidney transplant recipients.