中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2009年
12期
809-812
,共4页
付迎欣%宋文利%莫春柏%冯钢%郭雪西%张海明%王政禄%郑卫平%郑虹%沈中阳
付迎訢%宋文利%莫春柏%馮鋼%郭雪西%張海明%王政祿%鄭衛平%鄭虹%瀋中暘
부영흔%송문리%막춘백%풍강%곽설서%장해명%왕정록%정위평%정홍%침중양
肾移植%BK病毒%危险因素
腎移植%BK病毒%危險因素
신이식%BK병독%위험인소
Kidney transplantation%BK virus%Risk factors
目的 分析肾移植术后BK病毒(BKV)感染发生的危险因素.方法 应用荧光实时定量PCR技术检测129例肾移植患者血液中BKV并行尿液细胞学检查,记录BKV-DNA阳性及阴性组患者性别、年龄、供肾冷缺血时间,术前血液透析时间、急性排斥反应、是否发生移植肾功能延迟恢复、免疫抑制剂方案、合并其他病毒感染等指标.应用二项多元逻辑回归法分析肾移植术后BKV感染发生的危险因素.结果 129例患者血中BKV-DNA阳性20例(15.5%).阴性109例(84.5%);BKV-DNA阳性患者尿细胞学检测Decoy细胞阳性15例,尿Decoy细胞阳性率与血BKV-DNA阳性率之间有明显的相关性(r=0.428,P<0.01).回归分析结果 显示:供肾冷却血时间(χ~2=9.243,95%CI:1.099～1.545,P<0.05)、患者术前透析时间(χ~2=7.599,95%CI:1.038～1.243,P<0.05)、是否为亲体供肾(χ~2=4.150,95%CI:0.012～0.070,P<0.05)为BKV感染的危险因素.结论 荧光实时定量PCR及尿细胞学检查可以作为肾移植术后BKV感染的筛查指标;供肾冷缺血时间长、术前血液透析时间长、尸体供肾均可增加患者术后BKV感染的风险.
目的 分析腎移植術後BK病毒(BKV)感染髮生的危險因素.方法 應用熒光實時定量PCR技術檢測129例腎移植患者血液中BKV併行尿液細胞學檢查,記錄BKV-DNA暘性及陰性組患者性彆、年齡、供腎冷缺血時間,術前血液透析時間、急性排斥反應、是否髮生移植腎功能延遲恢複、免疫抑製劑方案、閤併其他病毒感染等指標.應用二項多元邏輯迴歸法分析腎移植術後BKV感染髮生的危險因素.結果 129例患者血中BKV-DNA暘性20例(15.5%).陰性109例(84.5%);BKV-DNA暘性患者尿細胞學檢測Decoy細胞暘性15例,尿Decoy細胞暘性率與血BKV-DNA暘性率之間有明顯的相關性(r=0.428,P<0.01).迴歸分析結果 顯示:供腎冷卻血時間(χ~2=9.243,95%CI:1.099～1.545,P<0.05)、患者術前透析時間(χ~2=7.599,95%CI:1.038～1.243,P<0.05)、是否為親體供腎(χ~2=4.150,95%CI:0.012～0.070,P<0.05)為BKV感染的危險因素.結論 熒光實時定量PCR及尿細胞學檢查可以作為腎移植術後BKV感染的篩查指標;供腎冷缺血時間長、術前血液透析時間長、尸體供腎均可增加患者術後BKV感染的風險.
목적 분석신이식술후BK병독(BKV)감염발생적위험인소.방법 응용형광실시정량PCR기술검측129례신이식환자혈액중BKV병행뇨액세포학검사,기록BKV-DNA양성급음성조환자성별、년령、공신랭결혈시간,술전혈액투석시간、급성배척반응、시부발생이식신공능연지회복、면역억제제방안、합병기타병독감염등지표.응용이항다원라집회귀법분석신이식술후BKV감염발생적위험인소.결과 129례환자혈중BKV-DNA양성20례(15.5%).음성109례(84.5%);BKV-DNA양성환자뇨세포학검측Decoy세포양성15례,뇨Decoy세포양성솔여혈BKV-DNA양성솔지간유명현적상관성(r=0.428,P<0.01).회귀분석결과 현시:공신냉각혈시간(χ~2=9.243,95%CI:1.099～1.545,P<0.05)、환자술전투석시간(χ~2=7.599,95%CI:1.038～1.243,P<0.05)、시부위친체공신(χ~2=4.150,95%CI:0.012～0.070,P<0.05)위BKV감염적위험인소.결론 형광실시정량PCR급뇨세포학검사가이작위신이식술후BKV감염적사사지표;공신랭결혈시간장、술전혈액투석시간장、시체공신균가증가환자술후BKV감염적풍험.
Objective To analyze the risk factors of BKV infection and compare the real-time PCR procedure and urinary sediment smears of patients checked for decoy cells. Methods The peripheral blood samples of 129 renal recipients were collected. According to the result of PCR, 129 patients were divided into 2 groups:①BKV-DNA(+);②BKV-DNA(-). The sex, age, cold ischemia time, hemotodialysis duration, immunosuppressive agent and other clinical parameters were compared between the 2 groups and a Logistic regression was performed to analyze the risk factors of BKV infection. Results There were 20(15. 5%) patients in BKV-DNA(+), 109(84. 5%)patients in BKV-DNA(-)group. Logistic regression found that the cold ischemia time, hematodialysis duration, living donor were significantly related to the BKV-DNA. The results of the real-time PCR procedure and urinary sediment smears of patients checked for decoy cells were related. Conclusion Real-time fluorescent quantitative PCR and urine decoy cell are good way for detection of BKV infection after renal transplantation. The cold ischemia time and hematodialysis duration and brain death donor were the risk factors of BKV infection post renal transplantation.
