检验医学
檢驗醫學
검험의학
LABORATORY MEDICINE
2014年
5期
493-497
,共5页
吴蓓颖%蔡刚%林佳菲%范臻佳%樊绮诗
吳蓓穎%蔡剛%林佳菲%範臻佳%樊綺詩
오배영%채강%림가비%범진가%번기시
BK病毒%移植%免疫抑制剂
BK病毒%移植%免疫抑製劑
BK병독%이식%면역억제제
BK virus%Transplantation%Immunosuppressor
目的:通过对患者血或尿BK病毒(BKV)载量的监测,探讨性别、年龄、人巨细胞病毒(HCMV)及免疫抑制剂浓度等对患者BKV载量的影响,以及BKV载量对患者疾病的影响。方法用实时荧光定量聚合酶链反应(PCR)检测移植患者血浆及尿液的BKV载量。分析血浆HCMV浓度及免疫抑制剂浓度对患者BKV载量的影响以及BKV载量高低对患者肾功能的影响。结果1985例移植和非移植肾病患者中BKV阳性242例(12.1%),其中血浆阳性211例(10.6%),尿液阳性118例(5.9%)。骨髓移植患者、肾移植患者及非移植肾病患者的BKV阳性率差异有统计学意义(P<0.01),几乎所有移植患者检测到BKV阳性都发生在移植后的前3个月中。HCMV的感染与否与患者的BKV载量差异无统计学意义(P=0.2729)。骨髓移植及肾移植患者血浆的免疫抑制剂浓度和环孢霉素A(CsA)浓度(>150 ng/mL)对患者BKV 载量的影响差异有统计学意义(P<0.01);他克莫司浓度(FK506)(>8.0 ng/mL)与BKV载量差异无统计学意义(P=0.2785)。BKV阳性患者与BKV阴性患者比较,肾功能中的肌酐(CREA)水平差异有统计学意义(P=0.0207)。结论 BKV的复制与性别、年龄、是否有HCMV合并感染无关,而与血浆免疫抑制剂的浓度有关。通过对BKV载量的连续监测,调节患者免疫抑制剂的浓度,可以减少由BKV带来的二次损伤。
目的:通過對患者血或尿BK病毒(BKV)載量的鑑測,探討性彆、年齡、人巨細胞病毒(HCMV)及免疫抑製劑濃度等對患者BKV載量的影響,以及BKV載量對患者疾病的影響。方法用實時熒光定量聚閤酶鏈反應(PCR)檢測移植患者血漿及尿液的BKV載量。分析血漿HCMV濃度及免疫抑製劑濃度對患者BKV載量的影響以及BKV載量高低對患者腎功能的影響。結果1985例移植和非移植腎病患者中BKV暘性242例(12.1%),其中血漿暘性211例(10.6%),尿液暘性118例(5.9%)。骨髓移植患者、腎移植患者及非移植腎病患者的BKV暘性率差異有統計學意義(P<0.01),幾乎所有移植患者檢測到BKV暘性都髮生在移植後的前3箇月中。HCMV的感染與否與患者的BKV載量差異無統計學意義(P=0.2729)。骨髓移植及腎移植患者血漿的免疫抑製劑濃度和環孢黴素A(CsA)濃度(>150 ng/mL)對患者BKV 載量的影響差異有統計學意義(P<0.01);他剋莫司濃度(FK506)(>8.0 ng/mL)與BKV載量差異無統計學意義(P=0.2785)。BKV暘性患者與BKV陰性患者比較,腎功能中的肌酐(CREA)水平差異有統計學意義(P=0.0207)。結論 BKV的複製與性彆、年齡、是否有HCMV閤併感染無關,而與血漿免疫抑製劑的濃度有關。通過對BKV載量的連續鑑測,調節患者免疫抑製劑的濃度,可以減少由BKV帶來的二次損傷。
목적:통과대환자혈혹뇨BK병독(BKV)재량적감측,탐토성별、년령、인거세포병독(HCMV)급면역억제제농도등대환자BKV재량적영향,이급BKV재량대환자질병적영향。방법용실시형광정량취합매련반응(PCR)검측이식환자혈장급뇨액적BKV재량。분석혈장HCMV농도급면역억제제농도대환자BKV재량적영향이급BKV재량고저대환자신공능적영향。결과1985례이식화비이식신병환자중BKV양성242례(12.1%),기중혈장양성211례(10.6%),뇨액양성118례(5.9%)。골수이식환자、신이식환자급비이식신병환자적BKV양성솔차이유통계학의의(P<0.01),궤호소유이식환자검측도BKV양성도발생재이식후적전3개월중。HCMV적감염여부여환자적BKV재량차이무통계학의의(P=0.2729)。골수이식급신이식환자혈장적면역억제제농도화배포매소A(CsA)농도(>150 ng/mL)대환자BKV 재량적영향차이유통계학의의(P<0.01);타극막사농도(FK506)(>8.0 ng/mL)여BKV재량차이무통계학의의(P=0.2785)。BKV양성환자여BKV음성환자비교,신공능중적기항(CREA)수평차이유통계학의의(P=0.0207)。결론 BKV적복제여성별、년령、시부유HCMV합병감염무관,이여혈장면역억제제적농도유관。통과대BKV재량적련속감측,조절환자면역억제제적농도,가이감소유BKV대래적이차손상。
Objective To monitor blood and urine BK virus (BKV)load and discuss the influence of sex,age, human cytomegalovirus(HCMV)and immunosuppressor on BKV load and the influence of BKV load on diseases. Methods BKV loads of plasma and urine from patients were measured by real-time fluorescence quantitation polymerase chain reaction(PCR).The influence of plasma HCMV concentration and immunosuppressor concentrantion on BKV load and the influence of high or low BKV load on diseases were analyzed.Results BKV was detected in 242 (12.1%)cases of 1 985 patients with or without transplantation.A total of 211 cases were positive in plasma (10.6%),while 118 cases were positive in urine (5.9%).Bone marrow transplantation,kidney transplantation and none transplantation patients had different BKV positive rates with statistical significance (P<0.01).Almost all cases of BKV positive occurred in the first 3 months after transplantation.There was no statistical significance between HCMV infection and BKV load (P=0.272 9 ).Among bone marrow transplantation and kidney transplantation patients,the differences of BKV load to plasma immunosuppessor concentration and cyclosporine A (CsA ) concentration (>150 ng/mL)had statistical significance (P <0.01),those to tacrolimus (FK506)(>8.0 mg/mL)had no statistical significance (P=0.278 5 ).For BKV positive and negative patients,there was statistical significance when monitoring serum creatinine (CREA)(P=0.020 7).Conclusions There is no relationship of sex,age and concurrent infection of HCMV infection with BKV replication.However,the concentration of plasma immunosuppressor is related with BKV replication. The secondary damage can be reduced by adjusting the dose of immunosuppressor from continuously monitoring BKV load.