肾移植受者BK病毒感染对长期预后的影响分析

摘要

Objective To explore the influences of BK virus (BKV) infection on the long-term prognosis of renal transplant recipients.Methods A total of 182 patients who received renal transplantation in our hospital were selected.According to the regular re-examination one year after the transplantation,the patients with post-operative BKV infection were selected as an observation group and those without BKV infection as a control group.The use of immunosuppressant was adjusted in the observation group and the treatment effects were followed up.The long term survival rate and the changes in renal function indexes of transplanted kidney between the two groups were compared.Results (1)71 patients had BKV infection(BKV urine disease) and five patients had BK virus associated nephropathy (BKVAN) after the operation.After the adjustment of immunosuppressant use,58 (81.7％) of the patients with BKV urine disease turned to negative,the turning negative time was (12.8±1.4)months,and two (40.0％) of the patients with BKVAN turned to negative.(2)There was no statistical difference in the survival rate of transplanted kidney and the function of transplanted kidney in the fifth year between BKV urine disease patients and non-BKV urine disease patients (P ＞ 0.05).Conc lusion After the adjustment of immunosuppressant use,the response to the treatment among patients with BKV infection is good.The long-term influences of BKV urine disease on the long term survival rate and renal function of transplanted kidney can be avoided.%目的 探讨肾移植受者BK病毒(BKV)感染对其长期预后的影响.方法 以在医院行肾移植的患者182例为研究对象,移植后1年内规律性复查,将术后BKV感染者作为观察组,将无BKV感染者作为对照组.观察组调整免疫抑制剂用法,并随访治疗效果,对比两组移植肾长期存活率和肾功能指标的变化.结果 (1)术后发生BKV感染者(BKV尿症)71例,其中BK病毒相关性肾病(BKVAN)5例.调整免疫抑制剂用法后,BKV尿症患者中,58例BKV转阴,占81.7％,转阴时间(12.8±1.4)个月,其中BKVAN患者转阴2例,占40.0％.(2)BKV尿症患者肾移植存活率及第5年移植肾功能与非BKV尿症患者相比,差异无统计学意义(P＞0.05).结论 调整免疫抑制剂用法后,BKV感染者治疗响应效果较好,可避免BKV尿症对移植肾长期存活率及肾功能指标的长期影响.