移植患者免疫抑制剂治疗后感染多瘤病毒及巨细胞病毒的现状

目的 探讨移植患者在接受免疫抑制剂他克莫司(FK506)治疗后感染多瘤病毒(BKV)与巨细胞病毒(CMV)情况,为器官移植研究提供流行病学依据.方法 采用FQ-PCR检测605例肝、肾、骨髓移植患者BKV和CMV的感染载量,ELISA检测患者FK506的血药浓度,并对结果进行统计分析.结果 605份标本中,共检测BKV感染者79例,感染率为13.06％,CMV感染148例,感染率为24.46％,双重病毒感染者为35例,感染率为5.79％;肝移植患者感染BKV和CMV阳性率为12.61％和15.97％,肾移植则分别为13.33％和27.08％,而6例骨髓移植标本则未发现病毒感染;CMV感染阳性率明显高于BKV,而病毒感染阳性者,则其FK506血药浓度较高(P＜0.05).结论 移植患者在使用免疫抑制剂FK506后易感染BKV和CMV,并且感染程度与FK506血药浓度相关.

Polyomavirus and cytomegalovirus infections in transplant patients after receiving immunosuppressant treatment

OBJECTIVE To explore polyomavirus(BKV) and cytomegalovirus(CMV) infections in transplant patients after taking immunosuppressive agents FK506,and to provide epidemiological basis for the study of organ transplantation.METHODS The viral load of BKV and CMV in 605 cases of liver,renal and bone marrow transplants were detected by FQ-PCR,and the concentrations of FK506 were measured by ELISA.The data were analyzed statistically.RESULTS In 605 samples,there were 79 with BKV infection,accounted for 13.1%,and 148 cases with CMV infection accounted for 24.5%.There were 35 cases infected dually with BKV and CMV(5.79%).The positive rates of BKV and CMV in liver transplant patients were 12.61% and 15.97%,and the rates in patients of renal transplants were 13.33% and 27.08%,respectively.However,BKV or CMV infections were not detected in patients with bone marrow transplants.In addition,the positive rate of CMV infection was higher than that of BKV infection,and the positive patients with viral infections were with high concentrations of FK506(P<0.05).CONCLUSION The transplant patients receiving the treatment with FK506 are susceptible to BKV and CMV infections,and the positive rates are associated with the concentrations of FK506.