BK病毒感染与移植肾阻力指数及凝血系统的关系

Correlation between BKV infection and renal transplantation resistance index as well as coagulation system

目的探讨BK病毒(BKV)感染与凝血系统及血流动力学变化之间的关系。方法收集183例肾移植患者,均进行肾脏彩色多普勒超声和BKV载量检测,凝血系统相关研究包括56例患者,根据BK病毒尿或病毒血症分组,非BKV感染115例,BKV感染68例,其中包括病毒血症者16例。计算肾叶间动脉阻力指数和肾小叶间动脉阻力指数。阻力指数>0.7判定为升高,以此反映肾血流动力学变化。测定凝血酶原时间、凝血酶原活性、活化部分凝血活酶时间、D-二聚体、纤维蛋白原和纤维蛋白降解产物等凝血指标。分析BKV感染与RI值及凝血指标的相关性。结果BKV感染者与非感染者比较,2组间叶间动脉阻力指数以及小叶间动脉阻力指数差异均无统计学意义(P>0.05)。以阻力指数0.7为界值,发现BK病毒尿症患者小叶间动脉阻力指数升高率较对照组低(P<0.05)。BKV感染与凝血酶原时间、凝血酶原活性、活化部分凝血活酶时间、D-二聚体、纤维蛋白原或纤维蛋白降解产物等凝血指标之间的关联无显著性(P<0.05)。结论BKV感染不升高移植肾RI,也不引起显著的系统性凝血障碍。

Objective To investigate the correlation between BKV infection and coagulation system as well as hemodynamic changes.Methods A total of 183 patients after renal transplantation who underwent color doppler ultrasound(CDU)examination and BKV loads test were enrolled in the study,who were divided into BK viruria group and viremia group including 115 cases of non BKV infection,68 cases of BKV infection and16 cases with viremia.Fifty-six patients were involved in research on coagulation system.The renal interlobar artery resistance index and renal interlobular artery resistance index were measured.The values that were higher than 0.7 were considered as an increase of RI,which indicated the hemodynamic changes.Moreover,coagulation indexes including prothrombin time,prothrombin activity,activated partial thromboplastin time,D-dimer assay,fibrinogen and fibrin degradation products were measured.In addition,the relationship between BKV infection and RI value as well as the coagulation indexes was analyzed.Results There were no significant differences in renal interlobar artery resistance index and renal interlobular artery resistance index between the two groups(P>0.05).With bounds of 0.7,the increasing rate of renal interlobular artery resistance index in BK viruria group was significantly lower than that in control group(P<0.05).There was no relationship between BKV infection and prothrombin time,prothrombin activity,activated partial thromboplastin time,D-dimer assay,fibrinogen and fibrin degradation products(P>0.05).Conclusion BKV infection does not lead to the increasing of renal transplantation RI and systematic coagulation disorders.