肾移植术后多瘤JC病毒感染

JC virus infection of posttransplantation in kidney transplant recipients

目的探究肾移植受者术后多瘤JC病毒(JCvirus,JCV)的感染情况及其感染的危险因素。方法采用巢式PCR方法检测32例肾移植病人术后尿液标本中的JCV-DNA,并以15例健康体检者为对照;免疫组化法检测肾移植病人外周血巨细胞病毒(cytomegalovirus,CMV)被膜抗原pp65;以病人的年龄、性别、免疫抑制方案、CMV感染作为影响JCV感染的危险因素。结果 JCV在肾移植病人中的感染率为43.8%,健康体检者为0.0%。与非感染者相比,感染者的年龄更大,使用MMF+强的松+环孢素的三联免疫抑制剂的感染比例更高,差异具有统计学意义(t=2.106,P=0.044;χ2=5.723,P=0.017)。结论 JCV在肾移植者中的感染率高,年龄和使用强的松+MMF+环孢素三联免疫抑制方案是影响JCV感染的危险因素。

Objective To investigate JC virus infection in kidney transplant recipients and JCV infection risk factors. Methods A total of 32 kidney transplant recipients and 15 health examination persons were enrolled in our study,JC viral load was measured using nested qualitative polymerase chain reaction assays of urine; CMV envelope antigen pp65 was detected by immunohistochemical assays of peripheal blood. And patients age,male,immunosuppressive therapy,CMV infection were collected as JCV infection factors. Results JC virus was detected in 43.8% of kidney transplant patients and 0.0% of health examination persons. Compared non JCV infected patients,JCV infected patients were older and more prone to using prednisone+MMF+CsA triple immunosuppressive regimen. There were significant difference between the two groups(t=2.106,P=0.044; χ2=5.723,P=0.017). Conclusion JCV is frequently detected in kidney transplant recipients. Elder and using of prednisone+MMF+CsA triple immunosuppression regimen can significantly increase the risk of JCV infection.