CAJ | 학술논문

为了探讨肾移植术后并发结核感染的发生原因、诊断及治疗经验,观察了11例肾移植术后并发结核感染的患者,结果为治愈6例,摘除移植肾4例,死亡1例.认为:(1)肾移植术后患者由于细胞免疫功能低下及接受抗排斥的免疫抑制剂,结核感染的发生率是一般人群的50倍.(2)肾移植术后高热应用抗生素效果不佳者即使化验结果阴性也不能排除结核菌感染.(3)一旦确立诊断早期使用抗结核药物,同时将激素减为最低量.(4)对药物治疗效果不佳者,立即停用免疫抑制剂,摘除移植肾,确保患者的生命安全.
위료탐토신이식술후병발결핵감염적발생원인、진단급치료경험,관찰료11례신이식술후병발결핵감염적환자,결과위치유6례,적제이식신4례,사망1례.인위:(1)신이식술후환자유우세포면역공능저하급접수항배척적면역억제제,결핵감염적발생솔시일반인군적50배.(2)신이식술후고열응용항생소효과불가자즉사화험결과음성야불능배제결핵균감염.(3)일단학립진단조기사용항결핵약물,동시장격소감위최저량.(4)대약물치료효과불가자,립즉정용면역억제제,적제이식신,학보환자적생명안전.
In order to investigate the pathogenesis, diagnosis and treatment of tuberculosis following kidney transplantation, 11 tuberculosis patients after renal transplantation were studied.The results showed that 6 were cured, 4 were extirpated the graft, and one died.It was believed that:Because of the immunosuppressant use and cellular immune hopofunction, the morbidity of tuberculosis after kidney transplantation is 50 times of that of the normal.The patients with high fever after kidney transplantation who had no efficiency to antibiotic should be suspected tubercu-losis even if the patients had negative examination results.Antibuterculotic should be used as early as possible when the diagnosis was confirmed and the prednisone should be extenuated to mini-mum.The patient with low efficiency to antibuberculotie should stop taking immunosuppressants and the renal grab extirpated.