肾移植患者肾组织和尿中巨细胞病毒DNA的动态观察及其临床意义

Identification of CMV DNA in urine and renal biopsies of allografted kidney

肾移植患者CMV感染对排异反应的影响认识不一,国内目前尚无资料可考.本文采用原位杂交及多聚酶链反应技术,动态观察了8例肾移植患者移植前供肾、移植后肾活检组织及肾活检当日尿标本中CMV-DNA的检出状况,结合肾组织病理形态学分析,发现①正常肾组织即有少数CMV感染;②肾组织CMV感染率随移植时间延长而增加;③CMV感染与移植肾慢性排异有较为密切的关系,可能是造成慢性排异反应发生的因素之一。

To assess the rule of CMV infection in kidney allograft rejection,serial survey was made in 8 cases receiving kidney transplantation. 19 biopsies of allografts were obtained from 8 cases at different post-operative period with urine specimen collected simultaneously. 7 cases had pre-operative specimen served as control. CMV-DNA in renal tissue was detected by means of in situ hybridization with a digoxigenin labelled CMV-DNA probe. While urine specimen were assessed by PCR technique. The results could be summarized as following (Tab. ): The relationship between CMV infection of renal tissue and rejection was also analyzed. It was found that among 9 cases showing acute rejection only 3 had CMV-DNA in their renal tissue,while 7 of the 8 cases having chronic rejection identified CMV-DNA in their renal specimen. In conclusion:①here is a lower incidence of CMV infection in normal kidney;② after transplantation,the incidence of CMV infection in renal allograft rises gradually;③there is a close relationship between CMV infection and chronic rejection.