肾移植受者活动性CMV感染的发生状况

Active cytomegalovirus infection after renal transplantation

目的 明确肾移植患者术前CMV感染的发生率和术后活动性CMV感染的发生规律。方法 检测27例健 康成人、以及我院2002年3月至2003年6月138例尿毒症患者肾移植前血清抗CMV抗体(抗CMV IgG、CMV IgM);观察肾 移植后CMV pp65抗原血症的动态变化。结果 27例健康成人血清抗CMV IgM均为阴性、抗CMV IgG的阳性率为70.4%、 外周血CMV pp65(+)白细胞数为0～4个/5×104WBC;尿毒症患者术前CMV IgG、CMV IgM阳性率分别为93.5%、7.1%, 肾移植后外周血CMV pp65(+)白细胞数为0～2280个/5×104WBC(其中>5者占87.0%)、其高峰期在术后第6～8周。 结论 肾移植受者术前CMV感染发生率明显高于健康人群,且至少有7.1%存在着活动性CMV感染;肾移植患者术后6 个月内,活动性CMV感染发生率高达86.96%;术后第6～8周是活动性CMV感染最严重的时期。

Objective To investigate the incidence of active cytomegalovirus (CMV) infection before renal transplantation, and the regularity of active CMV infection after renal transplantation. Methods Serum antibodies of CMV-IgG and CMV-IgM were detected in 27 healthy subjects, employed as control group, and in 138 uremia patients before renal transplantation. The variation in number of pp65 positive cells in peripheral blood of patients after renal transplantation was determined. Results Serum antibodies of CMV-IgM were all negative, and the rate of CMV-IgG positive was 70.4%, and the number of pp65 positive cells in peripheral blood was 0-4 cells in 5×10 4 WBCs. The positive rates of CMV-IgG and CMV-IgM were 93.5% and 7.1% respectively, and the number of pp65 positive cells in peripheral blood was 0-2 280 cells in 5×10 4 WBCs in patients after renal transplantation. The peak time of the number of pp65 positive cells in peripheral blood was in the period from 6 to 8 weeks after renal transplantation. Conclusion The incidence of active CMV infection before renal transplantation is at least 7.1%, which is higher than that in control group. Incidence of active CMV infection is 87.0% in the first 6 months after renal transplantation. Active CMV infection is the most serious in the period from 6 to 8 weeks after renal transplantation.