肾移植术后巨细胞病毒肺炎80例临床分析

Diagnosis and Treatment of Cytomegalovirus Pneumonia after Kidney Transplantation

目的探讨肾移植术后巨细胞病毒(cytomegalovirus,CMV)肺炎的诊断方法与治疗措施。方法回顾性分析作者医院80例肾移植术后并发CMV肺炎患者的临床病例资料。结果本组患者中CMV-PP65抗原检测阳性60例(75.0%),CMV-IgM抗体阳性50例(62.5%),DNA检测阳性70例(87.5%)。65例患者使用了甲基强的松龙治疗,50例患者使用了免疫球蛋白治疗,45例患者进行了机械通气。本组患者中65例治疗有效,有效率81.3%,死亡8例(10.0%)。结论肾移植术后CMV肺炎临床表现缺乏特异性,联合检测CMV-PP65抗原、CMV-IgM抗体及CMV-DNA对CMV肺炎具有较好的辅助诊断价值,综合治疗措施能有效治疗肾移植术后CMV肺炎。

Objective To investigate the diagnosis and treatment of the cytomegalovirus （CMV） pneumonia Mter kidney transplantation.Methods The clinical data of 80 CMV pneumonia patients were retrospectively analyzed.The clini- cal feature and treatment of CMV pneumonia were discussed. Results The positive rate of CMV-PP65, IgM, and DNA was 75.0 %,62.5 % and 87.5% respectively.Among 80 patients, 65 were administrated methylprednisolon, 50 were treated with immunoglobin, and 45 received ventilation. Sixty-five cases were cured and 10 died （10.0 %）.Conclusion The onset of CMV pneumonia is not specific, but combined detection of PP65, IgM, and CMV DNA may be useful diagnostic markers for CMV infection.The comprehensive therapy is effective for CMV pneumonia in patients with kidney transplantation.