醫(yī)學(xué)免費論文:肝移植術(shù)后巨細(xì)胞病毒感染的診斷和治療

醫(yī)學(xué)免費論文:肝移植術(shù)后巨細(xì)胞病毒感染的診斷和治療

【摘要】 目的 分析肝移植術(shù)后受體巨細(xì)胞病毒(CMV)感染的診斷和治療。方法 回顧性分析我科2000年11月至2007年12月期間進(jìn)行的肝移植病例，依據(jù)易感因素、臨床癥狀、外周血中CMV�睵P65和(或)CMV�睮gM及胸片明確診斷，以更昔洛韋抗病毒治療。結(jié)果 共收集資料111例(剔除相關(guān)資料不完整者)。發(fā)現(xiàn)CMV感染5例，CMV感染發(fā)生率為4.5%;其中2例發(fā)生CMV肺炎，CMV肺炎發(fā)生率為1.8%(占CMV感染的40%)，2例均好轉(zhuǎn)。活動性CMV感染3例，2例治愈，1例好轉(zhuǎn)。結(jié)論 CMV�睵P65檢測能夠?qū)�CMV感染患者做出早期診斷并且指導(dǎo)治療。更昔洛韋能夠有效治療CMV感染。

【關(guān)鍵詞】 肝移植;巨細(xì)胞病毒;診斷;治療

Diagnosis and treatment of cytomegalovirus pneumonitis

following liver transplantation

ZHANG Yong, L�a Yi, XIE Zhan�瞭ao, WAN Zhen, HU Liang�瞫huo,YU Liang, LIU Chang, ZHANG Xu�瞗eng, MA Feng

Department of Hepatobiliary Surgery, the First Affiliated Hospital,Medical School of Xi�餫n Jiaotong University, Xi�餫n 710061, China

ABSTRACT: Objective To study the diagnosis and treatment of cytomegalovirus (CMV) infection after liver transplantation. Methods The clinical data of 111 patients who received liver transplantation from November 2000 to December 2007 in our hospital were analyzed retrospectively. The recipients were diagnosed as having CMV infection by the predisposing factors, clinical symptoms and detection of CMV�睵P65 and CMV�睮gM in peripheral blood specimens in combination with chest X�瞨ay. The treatment of CMV infection was administration of Ganciclovir. Results Five recipients were diagnosed as having CMV infection, with the incidence of 4.5%. Two were diagnosed as having CMV pneumonitis, with the incidence of 1.8% (40% of the recipients having CMV infection). Two were both improved. Three were diagnosed as having CMV active infection. Two of them were cured and one was improved. Conclusion The detection of CMV�睵P65 is necessary for early diagnosis and guiding treatment of CMV infection. Ganciclovir can exert significant therapeutic effects on CMV infection醫(yī).學(xué)全.在.線zxtf.net.cn.

KEY WORDS: liver transplantation; cytomegalovirus; diagnosis; treatment

感染和排斥反應(yīng)是導(dǎo)致肝移植受體死亡和并發(fā)癥發(fā)生的最主要原因。巨細(xì)胞病毒(cytomegalovirus, CMV)感染是肝移植術(shù)后最常見的感染并發(fā)癥之一。本文回顧分析我院進(jìn)行的111例肝移植術(shù)后并發(fā)CMV感染的診斷和治療。

1 資料與方法

1.1 一般資料

收集我院2000年11月至2007年12月進(jìn)行的肝移植病例111例(剔除相關(guān)資料不完整者)。發(fā)現(xiàn)CMV感染5例，其中男4例，女1例�；�礎(chǔ)疾病分別為：乙型肝炎后肝硬化4例，酒精性肝硬化1例，其中發(fā)生肝癌1例。5例均為原位全肝移植。

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