肾移植病人结核感染的临床研究

Tuberculosis in renal recipients

自１９７７～１９９２年在７０６例同种异体尸体肾移植病人中共发现结核感染患者１４例，感染率为１．９８％。研究表明肾移植结核有其易感因素，如移植前有过结核感染、移植后急慢性排斥反应，合并其他感染或糖尿病等。发病部位以肺结核最多见，占５７．１％，其次为结核性胸膜炎，占２１．４％，腹膜炎、脑膜炎及肾结核各占７．１％。诊断方法以找病原菌为主，辅以体液的抗ＰＰＤ－ＩｇＧ测定，胸部Ｘ线片和治疗试验等。治疗以短程疗法为主，本组治愈率６４．３％，死亡率２８．６％。

Tuberculosis was found in 14 of 706 renal recipients between 1977 and 1992. The infection rate being 1.98%. There were many susceptible factors, such as tuberculous infection before renal transplantation, acute and chronic renal rejection, concurrent infections and CsA-induced diabetic millitus. The most common infected site of tuberculosis was lung (57.1%) and in turn pleura (21.4%) , peritoneal (7.1%), meninx (7.1%) and allograft (7.1%). Diagnosis mainly depens on looking for acid-fast bacilli, measurement of anti-PPD IgG,chest X-ray and therapeutic test. Short-course chemotherapy. The cure rate was 64. 3% and the mortality 28.6%.