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活体肾移植术后BK病毒感染情况及危险因素分析
活体肾移植术后BK病毒感染情况及危险因素分析
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活体肾移植术后BK病毒感染情况及危险因素分析
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活体肾移植术后BK病毒感染情况及危险因素分析
活体肾移植术后BK病毒感染情况及危险因素分析

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活体肾移植术后BK病毒感染情况及危险因素分析
活体肾移植术后BK病毒感染情况及危险因素分析
Journal Article

活体肾移植术后BK病毒感染情况及危险因素分析

2014
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Overview
目的研究活体肾移植术后BK病毒(BKV)感染情况,分析BKV感染及并发BK病毒性肾病(BKVN)的危险因素。方法选择2012年2月-2013年2月于解放军309医院器官移植研究所行活体肾移植术的43例受者作为研究对象,在术前及术后0.5、1、3、6、9、12、15个月检测尿液与血液标本中BKV DNA载量并记录检测结果,对部分出现不明原因血清肌酐持续升高或体内BKV DNA载量较高的受者行移植肾穿刺活检病理检查。按照检测结果将研究对象分为3组:BK病毒尿症组、BK病毒血症组、病理学确诊BKVN组,分别统计记录各研究对象性别、年龄、术后并发糖尿病、急性排斥反应、移植肾功能延迟恢复、术后肺部感染等非免疫相关因素资料以及术前免疫诱导方案与术后免疫抑制方案等免疫相关因素资料,分析影响活体肾移植术后BKV感染与发生BKVN的相关危险因素。结果经过15(6~18)个月的随访监测发现,病毒尿症发生率为46.5%(20/43),病毒血症发生率为14.0%(6/43),BKVN发生率为2.3%(1/43)。术后第6个月是病毒尿症与病毒血症发生率最高的时间点。术后服用FK506与活体肾移植术后BK病毒血症的发生呈正相关(r=0.319,P=0.037)。结论活体肾移植术后BK病毒血症、BKVN发生率较尸体肾移植术低,病毒尿症的发生率相似。术后应用以FK506为主的免疫抑制剂方案是活体肾移植术后BK病毒血症及进展为BKVN的独立免疫相关危险因素。

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