肾移植术后BK病毒感染及危险因素分析

发布时间：2018-08-07 21:12

【摘要】：目的目前国内关注肾移植术后BK病毒感染的研究较少。文中旨在研究国内肾移植术后BK病毒感染情况,分析肾移植术后BK病毒感染的危险因素。方法回顾性分析2015年6月至2016年7月于南京军区南京总医院肾脏科常规接受血、尿液BK病毒DNA检测的肾移植术后患者448例,并同时期纳入尿毒症透析患者167例、健康活体供者71例。根据血、尿液中BK病毒DNA的检测结果,将肾移植术后患者分为2组:BK病毒DNA阳性组(n=89,尿液或血及尿液BK病毒DNA同时阳性)、BK病毒DNA阴性组(n=359,血及尿液BK病毒DNA均阴性)。分析肾移植术后BK病毒感染情况,探讨肾移植患者的一般情况、术后并发症及免疫抑制剂方案等因素对BK病毒感染是否有影响。结果肾移植术后患者的尿液BK病毒DNA阳性率(19.9%)较尿毒症透析患者(6.3%)、健康活体供者(4.2%)升高(P0.001)。多因素logistic回归分析显示术后肺部感染(OR=3.468,95%CI:1.227~9.802)、急性排斥反应(OR=2.645,95%CI:1.142~6.127)、服用FK506(OR=2.408,95%CI:1.104~5.254)与BK病毒感染相关。结论肾移植术后要格外注意BK病毒的感染的发生率明显增加。术后肺部感染、急性排斥反应及应用以FK506为主的免疫抑制剂方案均可增加肾移植术后BK病毒感染的风险。
[Abstract]:Objective to study BK virus infection after renal transplantation in China. The purpose of this study was to study the BK virus infection after renal transplantation in China and to analyze the risk factors of BK virus infection after renal transplantation. Methods from June 2015 to July 2016, 448 renal transplantation patients received routine blood and urine BK virus DNA detection from the Renal Department of Nanjing General Hospital of Nanjing military region, and 167 uremic dialysis patients were included in the same period. 71 healthy living donors. According to the detection results of BK virus DNA in blood and urine, the patients after renal transplantation were divided into two groups: one group was positive for BK virus DNA (nx89) (positive for BK virus DNA in urine or blood), the other was DNA negative group for BK virus in urine (nnm359, both blood and urine were negative for BK virus DNA). To analyze the infection of BK virus after renal transplantation, to explore the general situation of renal transplantation patients, postoperative complications and immunosuppressant regimen to determine whether the infection of BK virus was affected by BK virus infection. Results the positive rate of BK-virus DNA in urine after renal transplantation (19.9%) was significantly higher than that in uremic dialysis patients (6.3%) and healthy living donors (4.2%) (P0.001). Multivariate logistic regression analysis showed that postoperative pulmonary infection (OR 3.468), acute rejection (OR 2.645% 95 CI: 1.1426.127) and FK506 (OR2.40895 CI: 1.1045.254) were associated with BK virus infection. Conclusion the incidence of BK virus infection should be increased significantly after renal transplantation. Postoperative lung infection, acute rejection and the use of immunosuppressant regimen based on FK506 can increase the risk of BK virus infection after renal transplantation.
【作者单位】：南京大学医学院附属金陵医院(南京军区南京总医院)国家肾脏疾病临床医学研究中心全军肾脏病研究所;
【分类号】：R699.2

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