中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2008年
3期
158-161
,共4页
瞿立辉%吕蓉%吴建永%王逸民%张建国%寿张飞%黄洪锋%陈江华
瞿立輝%呂蓉%吳建永%王逸民%張建國%壽張飛%黃洪鋒%陳江華
구립휘%려용%오건영%왕일민%장건국%수장비%황홍봉%진강화
肾移植%感染%更昔洛韦%复方新诺明
腎移植%感染%更昔洛韋%複方新諾明
신이식%감염%경석락위%복방신낙명
Kidney transplantation%Infection%Ganciclovir%Sulfamethoxazole trimethoprim
目的 探讨复方新诺明(SMZco)联合更昔洛韦预防肾移植术后早期严重肺部感染的疗效以及不同时期应用SMZco对肾移植受者Scr的影响.方法 选择我院2005年1月至2006年1月期间肾移植受者240例,分成SMZco联合更昔洛韦预防组(n=84)和单用更昔洛韦预防对照组(n=156);根据SMZco是否在术后2周内应用将84例SMZco联合更昔洛韦预防组患者分成2周内预防组(n=43)和2周后预防组(n=41).随访时间至少9个月,分析SMZco联合更昔洛韦预防对严重肺部感染发生率的影响和抗感染治疗效果以及不同时期应用SMZco对肾移植受者Scr的影响.结果 SMZco联合更昔洛韦预防组和单用更昔洛韦预防组两组在年龄、性别比例、缺血时间、群体反应性抗体(PRA)水平和补体依赖细胞毒试验(CDC)等方面差异无统计学意义.SMZco联合更昔洛韦预防组严重肺部感染的发生率和感染死亡比例显著低于单用更昔洛韦预防组(2/84比16/156,P=0.027;0/2比2/16,P＜0.01),但对尿路感染无明显作用.2周内预防组Scr异常发生率远高于2周后预防组(15/43比2/41,P＜0.01).两组因SMZco引起Scr异常升高者,在停用SMZco 1周内,Scr回到原有正常水平.结论 肾移植受者口服SMZco联合更昔洛韦预防能明显降低严重肺部感染的发生率和死亡比例.2周后开始口服SMZco预防对Scr影响较小.
目的 探討複方新諾明(SMZco)聯閤更昔洛韋預防腎移植術後早期嚴重肺部感染的療效以及不同時期應用SMZco對腎移植受者Scr的影響.方法 選擇我院2005年1月至2006年1月期間腎移植受者240例,分成SMZco聯閤更昔洛韋預防組(n=84)和單用更昔洛韋預防對照組(n=156);根據SMZco是否在術後2週內應用將84例SMZco聯閤更昔洛韋預防組患者分成2週內預防組(n=43)和2週後預防組(n=41).隨訪時間至少9箇月,分析SMZco聯閤更昔洛韋預防對嚴重肺部感染髮生率的影響和抗感染治療效果以及不同時期應用SMZco對腎移植受者Scr的影響.結果 SMZco聯閤更昔洛韋預防組和單用更昔洛韋預防組兩組在年齡、性彆比例、缺血時間、群體反應性抗體(PRA)水平和補體依賴細胞毒試驗(CDC)等方麵差異無統計學意義.SMZco聯閤更昔洛韋預防組嚴重肺部感染的髮生率和感染死亡比例顯著低于單用更昔洛韋預防組(2/84比16/156,P=0.027;0/2比2/16,P＜0.01),但對尿路感染無明顯作用.2週內預防組Scr異常髮生率遠高于2週後預防組(15/43比2/41,P＜0.01).兩組因SMZco引起Scr異常升高者,在停用SMZco 1週內,Scr迴到原有正常水平.結論 腎移植受者口服SMZco聯閤更昔洛韋預防能明顯降低嚴重肺部感染的髮生率和死亡比例.2週後開始口服SMZco預防對Scr影響較小.
목적 탐토복방신낙명(SMZco)연합경석락위예방신이식술후조기엄중폐부감염적료효이급불동시기응용SMZco대신이식수자Scr적영향.방법 선택아원2005년1월지2006년1월기간신이식수자240례,분성SMZco연합경석락위예방조(n=84)화단용경석락위예방대조조(n=156);근거SMZco시부재술후2주내응용장84례SMZco연합경석락위예방조환자분성2주내예방조(n=43)화2주후예방조(n=41).수방시간지소9개월,분석SMZco연합경석락위예방대엄중폐부감염발생솔적영향화항감염치료효과이급불동시기응용SMZco대신이식수자Scr적영향.결과 SMZco연합경석락위예방조화단용경석락위예방조량조재년령、성별비례、결혈시간、군체반응성항체(PRA)수평화보체의뢰세포독시험(CDC)등방면차이무통계학의의.SMZco연합경석락위예방조엄중폐부감염적발생솔화감염사망비례현저저우단용경석락위예방조(2/84비16/156,P=0.027;0/2비2/16,P＜0.01),단대뇨로감염무명현작용.2주내예방조Scr이상발생솔원고우2주후예방조(15/43비2/41,P＜0.01).량조인SMZco인기Scr이상승고자,재정용SMZco 1주내,Scr회도원유정상수평.결론 신이식수자구복SMZco연합경석락위예방능명현강저엄중폐부감염적발생솔화사망비례.2주후개시구복SMZco예방대Scr영향교소.
Objective To evaluate the prophylactic efficacy of compound sulfamethoxazole (SMZco)combined with ganciclovir on severe pulmonary infection in the early stage of renal transplantation. Methods Between January 2005 and January 2006,two hundred and forty renal allograft patients in our hospital were enrolled in this study.All the patients were divided into two groups.Group A(n=84)received oral SMZco combined with intravenous ganciclovir.Group B(n=156)received intravenous ganciclovir only as control.According to the time of SMZco administration,group A was divided into two subgroups:group A1(within 2weeks after transplantation,n=43)and group A2(more than 2 weeks after transplantation,n=41).All the patients were followed up for 9 months.Incidence of pulmonary infection and effects on graft function by SMZco at different time point were investigated. Results The incidence of severe pulmonary infection and mortality of infection were significantly lower in group A than those in group B (2/84 vs 16/156,P=0.027;0/2 vs 2/16,P＜0.01).There were no significant differences between two groups in terms of age,gender,warm or cold ischemia,complement dependent cytotoxieity test results,incidence of urinary infection and Scr.The incidence of elevatedScr was significantly lower in group A2 than that in group A1(15/43 vs 2/41,P＜0.01),however,all the elevated Scr returned to basal level within 1 week after SMZco was discontinued.Conclusions Oral SMZco combined with ganciclovir administration after renal transplantation is effective on preventing severe pulmonary infection and thus improves graft and recipient survival.The administration of oral SMZco initiated more than 2 weeks after transplantation is better for graft function.
