文章摘要
费 爽,黄正楷,周万里,陈 浩,陶 俊,韩志坚,谭若芸,顾 民.肾移植受者BK病毒感染及其危险因素的单中心研究[J].南京医科大学学报,2017,(5):588~592
肾移植受者BK病毒感染及其危险因素的单中心研究
A single-center epidemiological study of BK virus infection incidence and analysis of risk factors in renal transplantation recipients
投稿时间:2017-02-13  
DOI:10.7655/NYDXBNS20170514
中文关键词: 肾移植  BK病毒  BK病毒相关性肾病  危险因素
英文关键词: renal transplantation  BK virus  BK virus associated nephropathy  risk factors
基金项目:国家自然科学基金面上项目(81570676,81100532,81470981);江苏省“333”工程项目(BRA2015469);江苏省“科教兴卫”工程医学重点人才培养资助项目(RC2011055);江苏省“333高层次人才培养工程”项目(2011,2013);江苏省“六大人才高峰”资助项目(2010WSN-56, 2011-WS-033);江苏省卫生厅面上项目(H2009907)
作者单位
费 爽 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
黄正楷 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
周万里 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
陈 浩 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
陶 俊 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
韩志坚 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
谭若芸 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
顾 民 南京医科大学第一附属医院泌尿外科江苏 南京 210029 
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中文摘要:
      目的:探究肾移植受者术后BK病毒感染发生率并分析肾移植术后BKV感染的相关危险因素。 方法: 回顾性分析2014年12月—2015年12月在南京医科大学第一附属医院接受同种异体肾移植术的157例受者资料,根据受者血清和尿液中BKV-DNA 拷贝数量的不同将研究对象分为正常组、BK病毒血症组、BK病毒尿症组,统计各组对象的年龄、性别、肾脏原发病、透析类型、免疫抑制方案、移植肾功能延迟恢复(delayed graft function , DGF)、HLA错配、群体反应性抗体(panel reactive antibody , PRA)、急性排斥反应、免疫诱导方案、术后3个月内皮质类固醇用量和术后肺部感染等相关资料,利用Logistic回归模型分析BKV感染的相关危险因素。 结果:157例肾移植受者中,BK病毒血症发生率为11.46%(18例),BK病毒尿症发生率为35.03%(55例)。另外,确诊1例BK病毒相关性肾病(BK virus associated nephropathy , BKAVN),发生率为0.63%。单因素分析结果示免疫抑制方案 (P=0.031)和术后3个月内皮质类固醇用量(P=0.037)与BK病毒尿症的发生相关,而多因素分析结果亦显示免疫抑制方案(P=0.041,OR=2.146)及术后皮质类固醇用量总量(P=0.042,OR=1.739)与BK病毒尿症的发生具有相关性。结论:本中心研究结果显示BK病毒尿症较BK病毒血症发生率高,但确诊为BKVAN仅为1例。术后应用以他克莫司为主的免疫抑制剂方案和术后3个月内皮质类固醇用量是肾移植术后受者BK病毒尿症发生的相关危险因素。
英文摘要:
      Objective: To investigate the incidence of BK virus (BKV) infection in renal transplanted recipients and analyze the risk factors of BKV infection. Methods: By measuring BKV DNA loads in urine and blood samples of the patients, 157 renal transplanted recipients who had received renal transplantation in our hospital from Dec. 2014 to Dec. 2015 were divided into 3 groups: BK viruria group, BK viremia group and normal group. Data of each group was then recorded, including age, gender, kidney primarydisease, type of dialysis, preoperative immune induction therapy,delayed recovery of graft function(DGF), HLA mismatch, acute rejection, dosage of postoperative corticosteroid, postoperative immunosuppressive regimen, postoperative pulmonary infection, et al. The risk factors of postoperative BKV infection were analyzed by logistic regression. Results: It was found that the incidence of BKV viruria was 35.03% (55 cases), that of BKV viremia was 11.46% (18 cases), and that of BKVAN was 0.63% (1 case). Univariate analysis by Logistic regression analysis found that postoperative immunosuppressive regimen (P=0.031) and postoperative hormone dose (P=0.037) were significantly related to BKV viruria. Multivariate analysis by Logistic regression analysis found that postoperative immunosuppressive regimen(P=0.041,OR=2.146) and postoperative hormone dose (P=0.042,OR=1.739) were significantly related to BKV viruria. Conclusion: Incidence of BKV viruria was higher than that of BKV viremia. There was only one recipient diagnosed BKVAN. Postoperative immunosuppressive regimen and postoperative hormone dose may be the risk factors of BKV viruria.
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