论文部分内容阅读
目的 :探讨肾移植受者术后早期巨细胞病毒 (CMV)感染与远期肾功能的关系。 方法 :自 1999年8月～ 2 0 0 1年 6月 ,根据肾移植术后 6个月内CMV pp6 5抗原血症指数 (I)和持续时间 ,将 96例随访达 3年的肾移植受者分为CMV非感染组 (I =0 )、低感染组 (I =1～ 30 )、短期高感染组 (I >10 0 ,≤ 2周 )和长期高感染组 (I >10 0 ,≥ 8周 ) ,比较四组在肾移植 6个月时肾功能、移植肾活检组织中转化生长因子 β1(TGF β1)蛋白和mRNA表达 ;随访 3年期内肌酐清除率 (Ccr)减损量、肾功不全发生率 ,并对出现肾功不全者在血肌酐 (SCr)升高 1个月内进行移植肾穿剌活检 ,以明确病因。 结果 :在肾移植 6个月时 ,四组肾功能无明显差异 (P >0 0 5 ) ,但“长期高感染组”肾组织中TGF β1蛋白和mRNA表达量明显大于其他 3组 ;在肾移植 3年时 ,“长期高感染组”Ccr下降了(16 2± 7 2 )ml/min ,4 3 5 % (10 / 2 3)患者出现肾功能不全 ,二者均明显大于其他 3组 (P <0 0 1,P <0 0 5 )。肾功不全者 ,移植肾活检均证实为慢性移植肾肾病。 结论 :肾移植术后早期长时间严重的CMV感染是影响移植肾远期肾功能、导致慢性移植肾肾病的重要原因。
Objective: To investigate the relationship between postoperative early cytomegalovirus (CMV) infection and long-term renal function in renal transplant recipients. Methods: From August 1999 to June 2001, according to the CMV pp65 antigenicity index (I) and duration of 6 months after renal transplantation, 96 patients with renal transplant recipients who were followed up for 3 years The patients were divided into two groups: non-infected CMV group (I = 0), low-infected group (I = 1-30), short-term high infection group 8 weeks). The renal function and the expression of TGFβ1 protein and mRNA in the renal biopsy tissues were compared between the four groups at 6 months after renal transplantation. The levels of creatinine clearance (Ccr) Incomplete incidence of renal insufficiency and in patients with elevated serum creatinine (SCr) within 1 month of renal transplant biopsy to clear the cause. Results: There was no significant difference in renal function between the four groups at 6 months after renal transplantation (P> 0.05), but the expression of TGF-β1 protein and mRNA in the long-term high-infected group was significantly greater than that in the other three groups At 3 years of transplantation, Ccr decreased by (16 2 ± 7 2) ml / min in the long-term high-infection group and renal insufficiency in 435% (10/2 3), both significantly greater than the other 3 groups P <0 0 1, P <0 0 5). Renal insufficiency, renal biopsy were confirmed as chronic allograft nephropathy. CONCLUSIONS: Long-term severe CMV infection after renal transplantation is an important reason that affects the long-term renal function of renal allografts and leads to chronic allograft nephropathy.