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目的探讨肾移植术后巨细胞病毒(cytomegalovirus,CMV)肺炎的诊断方法与治疗措施。方法回顾性分析作者医院80例肾移植术后并发CMV肺炎患者的临床病例资料。结果本组患者中CMV-PP65抗原检测阳性60例(75.0%),CMV-IgM抗体阳性50例(62.5%),DNA检测阳性70例(87.5%)。65例患者使用了甲基强的松龙治疗,50例患者使用了免疫球蛋白治疗,45例患者进行了机械通气。本组患者中65例治疗有效,有效率81.3%,死亡8例(10.0%)。结论肾移植术后CMV肺炎临床表现缺乏特异性,联合检测CMV-PP65抗原、CMV-IgM抗体及CMV-DNA对CMV肺炎具有较好的辅助诊断价值,综合治疗措施能有效治疗肾移植术后CMV肺炎。
Objective To investigate the diagnosis and treatment of cytomegalovirus (CMV) pneumonia after renal transplantation. Methods The clinical data of 80 patients with CMV pneumonia after renal transplantation were analyzed retrospectively. Results The positive results of CMV-PP65 antigen in 60 patients (75.0%), CMV-IgM antibody in 50 patients (62.5%) and DNA test in 70 patients (87.5%) were positive. 65 patients treated with methylprednisolone, 50 patients treated with immunoglobulin, and 45 patients with mechanical ventilation. 65 cases of this group of patients treated effectively, the effective rate was 81.3%, 8 patients died (10.0%). Conclusions The clinical manifestations of CMV pneumonia after kidney transplantation are not specific. Combined detection of CMV-PP65 antigen, CMV-IgM antibody and CMV-DNA has a good value in the diagnosis of CMV pneumonia. Comprehensive treatment can effectively treat CMV after renal transplantation pneumonia.