摘要
目的探讨肾移植术后BK病毒感染患者预后与外周血相关指标的相关性。方法回顾性分析2018年8月至2021年8月中南大学湘雅二医院收治的131例肾移植术后首次感染BK病毒患者的病例资料,男93例(71.0%),女38例(29.0%)。年龄(37.5±11.3)岁。尸体供肾移植109例(83.2%),亲属供肾移植22例(16.8%)。肾移植术后首次感染BK病毒时间为(188.7±16.6)d。血清肌酐(127.5±39.5)μmol/L。血、尿BK病毒同时阳性25例(19.1%),仅尿BK病毒阳性106例(80.9%)。131例感染BK病毒后的治疗方案中,70例调低他克莫司血药浓度,12例将他克莫司换为环孢素,49例不详。25例血BK病毒阳性患者BK病毒DNA载量为5.6(2.4,12.3)×10^(3)拷贝/ml,感染时白细胞计数(WBC)(5.8±2.0)×10^(9)/L,血红蛋白(Hb)(122.0±22.4)g/L,血小板计数(PLT)(187.1±63.1)×10^(9)/L,中性粒细胞计数(NEUT)(3.9±1.7)×10^(9)/L,淋巴细胞计数(LYM)(1.5±0.8)×10^(9)/L,单核细胞计数(MONO)(0.4±0.2)×10^(9)/L,中性粒细胞与淋巴细胞比值(NLR)2.2(1.7,3.5),衍生中性粒细胞与淋巴细胞比值(dNLR)1.7(1.3,2.6),血小板与淋巴细胞比值(PLR)121.3(86.3,227.3),单核细胞与淋巴细胞比值(MLR)0.2(0.1,0.4),淋巴细胞与单核细胞比值(LMR)4.7±2.6。106例尿BK病毒阳性患者BK病毒DNA载量为20.4(0.4,2570.0)×10^(5)拷贝/ml,感染时WBC 6.6(4.8,9.1)×10^(9)/L,Hb(129.0±24.5)g/L,PLT 188.0(147.3,226.5)×10^(9)/L,NEUT 4.6(3.0,6.6)×10^(9)/L,LYM(1.7±0.8)×10^(9)/L,MONO 0.4(0.3,0.5)×10^(9)/L,NLR 2.8(1.9,3.9),dNLR 2.1(1.5,3.0),PLR 120.5(87.0,163.2),MLR 0.2(0.1,0.4),LMR 4.5(2.8,6.7)。根据70例调低他克莫司血药浓度患者治疗前后血、尿BK病毒DNA载量变化情况(分组原则优先考虑血BK病毒DNA载量,其次是尿BK病毒DNA载量),将患者分为BK病毒升高组和BK病毒下降组,比较两组治疗后WBC、Hb、PLT、NEUT、LYM、MONO、NLR、dNLR、PLR、MLR、LMR、他克莫司血药浓度及变化差值、血肌酐及变化差值的差异。结果25例血BK病毒阳性患者BK�
Objective To investigate the correlation between the prognosis of patients infected with BK virus after renal transplantation and their peripheral blood related indexes.Methods 131 patients from the Renal Transplantation Department of the Second Xiangya Hospital of Central South University who underwent renal transplantation and firstly infected with BK virus after the surgery during the period from August 2018 to August 2021 were retrospectively analyzed.93 males(71.0%)and 38 females(29.0%).The average age was(37.5±11.3)years old.109 cases underwent cadaveric kidney transplant(83.2%)and 22 cases underwent relatives kidney transplant(16.8%).The onset time of the first infection with BK virus after renal transplantation was(188.7±16.6)days,and the serum creatinine was(127.5±39.5)μmol/L.25 patients(19.1%)infected with BK virus were positive in blood and urine at the same time,and 106 patients(80.9%)infected with BK virus were positive only in urine.Among 131 patients infected with BK virus,70 patients were treated by lowering the blood concentration of tacrolimus to enhance immunity,12 patients were treated by switching tacrolimus to cyclosporine,and 49 patients had incomplete follow-up data.The DNA load of BK virus in 25 patients[5.6(2.4,12.3)×10^(3)copies/ml]positive in blood,white blood cell count(WBC)(5.8±2.0)×10^(9)/L,hemoglobin(Hb)(122.0±22.4)g/L,platelet count(PLT)(187.1±63.1)×10^(9)/L,neutrophil count(NEUT)(3.9±1.7)×10^(9)/L,lymphocyte count(LYM)(1.5±0.8)×10^(9)/L,monocyte count(MONO)(0.4±0.2)×10^(9)/L,neutrophil to lymphocyte ratio(NLR)2.2(1.7,3.5),derived neutrophil to lymphocyte ratio(dNLR)1.7(1.3,2.6),platelet to lymphocyte ratio(PLR)121.3(86.3,227.3),monocyte to lymphocyte ratio(MLR)0.2(0.1,0.4)and lymphocyte to monocyte ratio(LMR)4.7±2.6.The DNA load of BK virus in 106 patients[20.4(0.4,2570.0)×10^(5)copies/ml]positive in urine,WBC 6.6(4.8,9.1)×10^(9)/L,Hb(129.0±24.5)g/L,PLT 188.0(147.3,226.5)×10^(9)/L,NEUT 4.6(3.0,6.6)×10^(9)/L,LYM(1.7±0.8)×10^(9)/L,MONO 0.4(0.3,0.5)×10^(9)/L
作者
水看看
彭龙开
张和栋
谢续标
蓝恭斌
彭风华
汤周琦
彭家威
李腾芳
代贺龙
Shui Kankan;Peng Longkai;Zhang Hedong;Xie Xubiao;Lan Gongbin;Peng Fenghua;Tang Zhouqi;Peng Jiawei;Li Tengfang;Dai Helong(Department of Kidney Transplantation,Organ Transplantation Center,The Second Xiangya Hospital of Central South University,Clinical Medicine Research Central for Organ Transplantation in Hunan Province,Changsha 410011,China)
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2022年第12期898-903,共6页
Chinese Journal of Urology
