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医学免费论文:肝移植术后巨细胞病毒感染的诊断和治疗
【摘要】 目的 分析肝移植术后受体巨细胞病毒(CMV)感染的诊断和治疗。方法 回顾性分析我科2000年11月至2007年12月期间进行的肝移植病例，依据易感因素、临床症状、外周血中CMVPP65和(或)CMVIgM及胸片明确诊断，以更昔洛韦抗病毒治疗。结果 共收集资料111例(剔除相关资料不完整者)。发现CMV感染5例，CMV感染发生率为4.5%;其中2例发生CMV肺炎，CMV肺炎发生率为1.8%(占CMV感染的40%)，2例均好转。活动性CMV感染3例，2例治愈，1例好转。结论 CMVPP65检测能够对CMV感染患者做出早期诊断并且指导治疗。更昔洛韦能够有效治疗CMV感染。
【关键词】 肝移植;巨细胞病毒;诊断;治疗
Diagnosis and treatment of cytomegalovirus pneumonitis
following liver transplantation
ZHANG Yong, L Yi, XIE Zhantao, WAN Zhen, HU Liangshuo,YU Liang, LIU Chang, ZHANG Xufeng, MA Feng
Department of Hepatobiliary Surgery, the First Affiliated Hospital,Medical School of Xian Jiaotong University, Xian 710061, China
ABSTRACT: Objective To study the diagnosis and treatment of cytomegalovirus (CMV) infection after liver transplantation. Methods The clinical data of 111 patients who received liver transplantation from November 2000 to December 2007 in our hospital were analyzed retrospectively. The recipients were diagnosed as having CMV infection by the predisposing factors, clinical symptoms and detection of CMVPP65 and CMVIgM in peripheral blood specimens in combination with chest Xray. The treatment of CMV infection was administration of Ganciclovir. Results Five recipients were diagnosed as having CMV infection, with the incidence of 4.5%. Two were diagnosed as having CMV pneumonitis, with the incidence of 1.8% (40% of the recipients having CMV infection). Two were both improved. Three were diagnosed as having CMV active infection. Two of them were cured and one was improved. Conclusion The detection of CMVPP65 is necessary for early diagnosis and guiding treatment of CMV infection. Ganciclovir can exert significant therapeutic effects on CMV infection医.学全.在.线www.lindalemus.com.
KEY WORDS: liver transplantation; cytomegalovirus; diagnosis; treatment
感染和排斥反应是导致肝移植受体死亡和并发症发生的最主要原因。巨细胞病毒(cytomegalovirus, CMV)感染是肝移植术后最常见的感染并发症之一。本文回顾分析我院进行的111例肝移植术后并发CMV感染的诊断和治疗。
1 资料与方法
1.1 一般资料
收集我院2000年11月至2007年12月进行的肝移植病例111例(剔除相关资料不完整者)。发现CMV感染5例，其中男4例，女1例。基础疾病分别为：乙型肝炎后肝硬化4例，酒精性肝硬化1例，其中发生肝癌1例。5例均为原位全肝移植。
