肾移植前巨细胞病毒感染状况及其对术后的影响

Active cytomegalovirus infection before renal transplantation and its effect on the patients

目的明确肾移植前尿毒症患者活动性巨细胞病毒(CMV)感染的发生状况及其对术后的影响.方法自2002年6月～2003年9月,使用荧光素标记的抗CMV-pp65单克隆抗体,检测176例肾移植患者术前外周血CMV-pp65抗原血症;肾移植后每2～4周复查1次,共为期6个月;分析术前CMV-pp65抗原血症状况对术后患者CMV-pp65抗原血症强度和CMV病发生率的影响;另于同期内检测26例健康成人CMV-pp65抗原血症做相关对照.结果 26例健康成人CMV-pp65抗原血症均为(-);肾移植前有11.4%(20/176)的尿毒症患者CMV-pp65抗原血症为(+);这类患者肾移植后发生高活动性CMV感染(即CMV-pp65抗原血症指数＞100)和CMV病的发生率均明显高于移植前CMV-pp65抗原血症为(-)的患者.结论肾移植前活动性CMV感染高达11.4%;术前活动性CMV感染是导致肾移植后发生高活动性CMV感染和CMV病的重要原因.

Objective To discover the matter of active cytomegalovirus (CMV) infection before renal transplantation and its effect on the patients after transplantation.Methods The numbers of pp65 positive cells in peripheral blood in 26 normal persons who were used as control and 176 uremia patients before renal transplantation were determined between June 1, 2002 and September 30, 2003. The variations of number of pp65 positive cells in peripheral blood in patients after renal transplantation were investgated.Results In control group the number of pp65 positive cells in peripheral blood was 0 /5×10 4 WBC. Before renal transplantation there was 11.4 percent of uremia patients whose pp65 positive cell counting was more than 0 cell /5×10 4 WBC.In this kind of patient the case number of serious active CMV infection(pp65 positive cell counting was more than 100 cells /5×10 4 WBC) and CMV disease after renal transplantation was more than others . The difference was significant.Conclusions The findings suggest that active CMV infection before renal transplantation is an important sake that causes serious active CMV infection and even CMV disease after renal transplantation.