巨细胞病毒抗原检测对巨细胞病毒病预防的意义

A clinical research of CMV antigenemia in the prevention of CMV diseases in renal transplant recipients

目的；提高对肾移植术后巨细胞病毒（ＣＭＶ）病的防治水平。方法；应用免疫组织化学方法（ＬＳＡＢ法）对１９９７年度肾移植患者进行ＣＭＶ抗原检测．对检查阳性的患者采用丙氧鸟苷预防性治疗，并与１９９６年度未预防治疗组进行对照。结果：１９９７年预防性治疗后，ＣＭＶ病发病率为３．１％（５／１６０），病死率为２０．０％（１／５），而１９９６年未预防治疗组，ＣＭＶ病发病率为１１．７％（１６／１３６），病死率为４３．８％（７／１６）。结论：对肾移植术后ＣＭＶ抗原检测阳性患者预防性应用丙氧鸟苷能显著降低ＣＭＶ病的发生率和病死率。

Purposes To cut down the incidence and mortality of Cytomegalovirus(CMV) diseases in renal transplant recipients. Methods: Immunohistochemical technique(LSAB method) was used to detect CMV antigens in peripheral white blood cells in 1997. Ganciclovir was intravenously used as prophylactic therapy for patients who were positive in CMV antigen test,which compared with patients in 1996 who got no prophylactic therapy. Results:Our results show that:In 1996,the incidence and mortality of CMV diseases were 11. 7%(16/ 136) and 43. 8%(7/16) respectively in a total of 136 patients,however,with the aid of prophylactic therapy in 1997, the incidence of CMV disease in 160 renal transplant recipients was 3. 1 %(5/160),and the mortality was 20. 0%(1/5). Conclusion: Prophylactic therapy with ganciclovir for CMV antigen positive patients could obviously cut down the incidence and mortality of CMV disease, this prophylactic protocol is effective and economically acceptable.