摘要
目的探讨缬更昔洛韦是否能够有效预防肺移植术后巨细胞病毒(CMV)感染。方法回顾性分析2015年9月-2017年4月河南省人民医院胸外科收治的11例肺移植患者的临床资料,其中双肺移植1例,单肺移植10例。根据术前CMV血清学IgG、IgM检测、HCMV-DNA检测及供体肺血清学检测患者分为高危、中危及低危患者,本中心患者均为CMV感染中危者,术后3个月内口服缬更昔洛韦900 mg/d,其余药物常规服用。常规定期监测血常规、肝肾功能、感染指标、肺功能及胸部CT。结果共纳入11例手术,男性9例,女性2例;平均年龄(43.5±13.1)岁;其中原发病为COPD呼吸衰竭1例,矽肺6例,弥漫性肺大疱1例,肺间质纤维化3例。术后2例随访丢失,9例定期监测CMV抗体、白细胞及血小板等指标,随访至今未发现CMV感染迹象。结论肺移植术后口服缬更昔洛韦3个月能够有效预防CMV感染,有助于降低术后并发症。
Objective To explore the prophylactic effect of Valganciclovir on cytomegalovirus（CMV） infection in lung transplantation. Methods The clinical data of 11 patients lung transplantation between September 2015 to April 2017 in thoracic surgery department, Henan Province People＇s Hospital, were analyzed retrospectively. One lung transplantation in 1 case, single lung transplantation in 10 cases. The patients were divided into high risk, middle risk and low risk according to the preoperative CMV serological Ig G, Ig M, HCMV-DNA and donor pulmonary serology detection. The patients received a prophylaxic regimen of oral valganciclovir 900 mg/d for 3 months after operation. The blood, liver and kidney function, infection indicators, lung function and chest CT were monitored. Results Data of 11 patients were analyzed, including 9 male and 2 female patients;the average age was（43.5±13.1）years old;COPD in 1 case, silicosis in 6 cases, diffuse lung blisters in 1 case, pulmonary interstitial fibrosis in 3 cases. 2 postoperative cases were followed up for loss, the CMV antibodies, white blood cells and platelets were monitored in other cases. No signs of CMV infection had been found in the 9 patients. Conclusion The preventive prophylaxis using Valganciclovir 3 months after the standard is exact and it may contribute to reducing postoperative complications.
作者
徐磊
胡为才
张文平
张全
李基伟
朱晓明
张宁
陈晓
务森
魏立
Xu Lei Hu Weicai Zhang Wenping Zhang Quan Li Jiwei Zhu Xiaoming Zhang Ning Chen Xiao Wu Sen Wei Li.(Henan Provincial People ＂s Hospital, Thoracic surgery, Zhengzhou 450003, Henan, Chin)
出处
《实用器官移植电子杂志》
2017年第5期347-350,共4页
Practical Journal of Organ Transplantation(Electronic Version)
基金
河南省卫计委医学科技攻关项目(201702152)
关键词
肺移植手术
缬更昔洛韦
巨细胞病毒感染
预防
Lung transplantation
Valganciclovir
Cytomegalovirus infection
Prevention
