肝移植术后巨细胞病毒感染(附31例临床分析)

Cytomegalovirus infection after liver transplantation: a review of 31 cases.

目的 探讨肝移植术后巨细胞病毒感染的诊断和防治。方法 回顾分析 1993年 4月至 1999年 6月我科所进行的 31例肝移植病人临床资料 ,并结合文献进行讨论。结果 共有 5例病人发生活动性巨细胞病毒感染 ,发生率为 16 1% ,其中 1例发生巨细胞病毒性肺炎 ,其余 4例为无临床症状的活动性巨细胞病毒感染。 4例治愈 ,1例死亡。与巨细胞病毒感染相关的病死率为 3 2 %。结论 外周血巨细胞病毒抗原血症测试是诊断巨细胞病毒感染的有效检测手段。应重视术前供受体、术后受者巨细胞病毒感染的监测 ,慎用抗淋巴细胞免疫球蛋白 ,更昔洛韦能有效治疗巨细胞病毒感染。

Objective To study the prophylaxis, diagnosis and treatment of cytomegalovirus (CMV) infection after liver transplantation. Methods The data of 31 patients received liver transplantation from April 1993 to June 1999 were retrospectively reviewed. Results CMV infection occurred in 5 cases (16 1%). Of the 5, 1 developed CMV pneumonia and 4 were active asymptomatic CMV infection. One patient died and the other 4 were cured. The morbidity related to CMV infection was 3.2%. Conclusions Detection of CMV antigenemia in peripheral blood leukocytes of the transplant recipients is an effective method in testing active CMV infection. It is important to monitor the donor recipient CMV infection status and carefully use the antilymphocyte immune globulin. Ganciclovir can exert significant therapeutic effects on CMV infection.