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目的探讨肾移植术后巨细胞感染对远期肾功能的影响。方法选择2005年3月-2007年3月医院收治的同种异体肾移植术患者86例,依据术后<6个月所规定的检查中,抗原血症指数分为4组;对4组患者6个月后血肌酐(Cr)和肌酐清除率(Ccr)、术后<3年Ccr年下降速度及肾功能不全发生率、患者移植肾内TGF-β1mRNA和TGF-β1蛋白的表达情况进行比较分析。结果患者肾移植术后6个月后血肌酐和肌酐变化不明显,差异无统计学意义;而长期高活动感染组患者肾移植术后3年内Ccr年下降速度仅为(4.39±3.67)ml/min,肾功能不全发生率为42.86%,与其他组相比均明显降低;移植肾内TGF-β1mRNA的相对含量为1.29±0.27,TGF-β1蛋白的表达为(12.69±2.17)×106均明显提高,差异有统计学意义(P<0.05)。结论对于肾移植术后患者进行活动性巨细胞病毒(CMV)感染的监测是十分必要的,不仅可以作为患者治疗方案的依据,还能够有效地改善患者移植肾的远期效果,有利于患者生活质量的提高,具有十分重要的临床意义。
Objective To investigate the effect of cytomegalovirus infection on long-term renal function after renal transplantation. Methods Eighty-six patients with renal allograft admitted to our hospital from March 2005 to March 2007 were selected and divided into 4 groups according to the examination of less than 6 months postoperatively. After 6 months, serum creatinine (Cr) and creatinine clearance rate (Ccr), postoperative Ccr annual decline rate and incidence of renal insufficiency, TGF-β1 mRNA and TGF-β1 protein expression were compared analysis. Results There was no significant difference in serum creatinine and creatinine 6 months after renal transplantation, but the rate of decline in Ccr within 3 years after renal transplantation in long-term high-activity infection group was only (4.39 ± 3.67) ml / min, the incidence of renal insufficiency was 42.86%, which was significantly lower than other groups. The relative content of TGF-β1 mRNA in renal transplantation was 1.29 ± 0.27, and the expression of TGF-β1 protein was (12.69 ± 2.17) × 106 Increase, the difference was statistically significant (P <0.05). Conclusion It is necessary to monitor active cytomegalovirus (CMV) infection in patients after renal transplantation, which not only can be used as the basis for the treatment of patients, but also can effectively improve the long-term effect of renal transplant patients, which is conducive to the life of patients Quality improvement, has a very important clinical significance.