肾移植术后微小病毒感染14例临床分析

Clinical analysis of 14 cases of human papillomavirus infection after renal transplantation

目的:分析肾移植术后微小病毒感染的危险因素及免疫功能变化,为早期预防性治疗人类微小病毒B19(HPV B19)感染提供前期研究基础。方法:收集2018年5月至2020年5月本院22例肾移植术后受者的临床资料,对应捐献供体11例,其中HPV B19阳性受者14例、同一供体对侧供肾HPV B19阴性受者8例。回顾性分析HPV B19阳性受者治疗前、后的临床资料。对同一供体受者间术前的因素和不同受者间的供体的因素进行统计学分析。比较HPV B19阳性受者治疗前、后与阴性受者的免疫功能变化。结果:双侧受体感染阳性的供体年龄大于单侧受体阳性和全阴受体的供体(P<0.05)。HPVB19阳性受者治疗后血红蛋白(HGB)水平、CD4+T细胞数和CD8+T细胞数均较治疗前升高(均P<0.05)。结论:高龄供体和免疫功能低可能是HPV B19感染的潜在危险因素;及早免疫功能监测和预防治疗有利于防控受者HPV B19感染。

Objective:To analyze the risk factors and the immune function changes caused by human papillomavirus(HPV)infection after renal transplantation,and to provide a preliminary research basis for early prophylactic treatment of human microvirus B19(HPV B19)infection.Methods:Clinical data of 22 post-transplant recipients in our hospital from May 2018 to May 2020 were collected,corresponding to 11 cases of donors,including14 cases of HPV B19-positive recipients and 8 cases of HPV B19-negative recipients of the contralateral kidney from the same donor.The clinical data of HPV B19-positive recipients before and after treatment were retrospectively analyzed.Statistical analysis was performed on the preoperative factors among recipients of the same donor and factors among different recipients of the donor.Changes in immune function before and after treatment in HPV B19 positive recipients were compared with negative recipients.Results:Donors with positive bilateral recipients infection were older than those with positive unilateral recipients and all-negative recipients(P<0.05).The hemoglobin(HGB)levels,CD4T-cell counts and CD8T-cell counts were higher in HPV B19-positive recipients after treatment than before treatment(all P<0.05).Conclusion:Advanced donor age and low immune function may be potential risk factors for HPV B19 infection;early immune function monitoring and prophylactic treatment are beneficial for the prevention and control of HPV B19 infection in recipients.