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肾移植术后带状疱疹的特征及诊治 预览 被引量:1

Clinical diagnosis and treatment features of herpes zoster in renal transplantation recipients
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摘要 目的 探讨肾移植患者术后带状疱疹的诊治特点.方法 回顾性分析我院1991年1月至2007年1月30例肾移植术后并发带状疱疹患者的临床资料.结果 肾移植患者术后带状疱疹的发病率为1.5%(30/2037),低于早期国外的报道.发病时间从术后2个月到90个月不等,平均为19.5个月,66.7%(20/30)发生于术后1~2年.18例表现为寻常型,12例为特殊型.5例合并局部细菌感染,6例合并全身性感染.常规予抗病毒、应用丙种球蛋白及局部治疗;表现较重者适当调整免疫抑制方案,合并其他感染者采取相应抗感染治疗.所有患者皮肤带状疱疹恢复良好,3例因同时伴有其他严重感染死亡,表现较重者调整免疫抑制方案后迅速恢复.1例合并角膜疱疹者恢复较慢,恢复后视力未受影响.5例合并慢性移植物肾病者治疗期间应用超过10 d的静脉抗病毒治疗后血清肌酐值上升12~25 μmol/L,停药或改用口服用药后恢复.1例调整免疫抑制方案后发生急性排斥,经应用甲泼尼松冲击治疗后恢复.结论 肾移植术后易并发带状疱疹,其病情常较重,病程也较长.发生的带状疱疹易累及非典型部位或合并其他感染.治疗时需要进行综合治疗,并需密切观察病情,必要时调整免疫抑制治疗方案. Objective To study the clinical diagnosis and treatment features of herpes zoster in renal transplant recipients.Methods The clinical data of 30 cases of herpes zoster in renal transplant recipients in our hospital from January 1991 to January 2007 were analyzed,retrospectively.Results The morbility of herpes zoster in renal transplantation recipients was 1.5%(30/2037) and lower than that in the early foreign report.The time of onset was 2 to 90 months after kidney transplantation and the median time was 19.5 months.Twenty cases(66.7%) occurred in 1 to 2 years after renal transplantation.Five cases had a local complicated bacterial infection and 6 cases had a systemic complicated infection in the course of disease.Antiviral treatment(aciclove or ganciclovir) and intravenous γ-immunoglobulin with local treatment were applied in the cases of common clinical type.In the group of severe clinical type,the immunosuppressants were adjusted at the same time,and antibiotics were applied to control the complicated infection.The dermatic herpes zoster of all cases recovered well,while 3 cases died because of other complicated severe infection.The patients with severe clinical type recovered quickly after the adjustment of immunosuppressants.One case complicated with corneal herpes recovered slowly while the eyesight was normal in the end.Five cases with chronic allograft nephronia had an increase in serum creatinine level with the range of 12 to 25 μmol/L after a long-time(>10 days) intravenous antiviral treatment,and all recovered after changing to oral medcine or stopping treatment.One case had acute rejection after immunosuppressants adjustment and recovered after treatment with methylprednisolone.Conclusions Renal transplant recipients were prone to be infected by varicella zoster virus.The symptom is variant in different patients,however,it is often severe and protracted.The herpes zoster will spread to atypical positions or go with other pathogenic infection such as cytomegalovirus infection without timely treatment
作者 朱耿隆 王长希 陈立中 费继光 邓素雄 邱江 李军 陈国栋 ZHU Geng-long  WANG Chang-xi  CHEN Li-zhong  FEI Ji-guang  DENG Su-xiong  QIU Jiang  LI Jun  CHEN Guo-dong  
机构地区 广州市
出处 《中华实验和临床感染病杂志(电子版)》 CAS 2008年第3期 186-191,共6页 Chinese Journal of Experimental and Clinical Infectious Disease(Electronic Version)
关键词 肾移植 带状疱疹 治疗 Kidney transplantation Herpes zoster Therapeutics
作者简介 王长希 Email: zhugenglong@hotmail.com 通讯作者
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参考文献14

  • 1王敏力,沈琦.水痘-带状疱疹免疫球蛋白研究进展[J].中国生物制品学杂志,2007,20(9):701-704. 被引量:11
  • 2[2]Fehr T,Bossart W,Wahl C,et al.Disseminated varicella infection in adult renal allograft recipients:four cases and a review of the literature.Transplantation,2002,73:608-611. 被引量:1
  • 3[3]Hambleton S,Gershon AA.Preventing varicella-zoster disease.Clin Microbiol Rev,2005,18:70-80. 被引量:1
  • 4[4]Grant RM,Weitzman SS,Sheman CG,et al.Fulminant disseminated varicella zoster virus infection without skin involvement.J Clin Virol,2002,24:7-12. 被引量:1
  • 5[5]Stratman E.Visceral zoster as the presenting feature of disseminated herpes zoster.J Am Acad Dematol,2002,46:771-774. 被引量:1
  • 6[6]Gourishankar S,McDermid JC,Jhangri GS,et al.Herpes zoster infection following solid organ transplantation:incidence,risk factors and outcomes in the current immunosuppressive era.Am J Transplant,2004,4:108-115. 被引量:1
  • 7宋宁宏,宋宁静,张炜,顾民,冯宁翰,钱立新,华立新,殷长军,徐正铨,眭元庚,唐宁枫,吴宏飞.肾移植术后带状疱疹的诊治[J].中华器官移植杂志,2006,27(1):8-10. 被引量:14
  • 8贾冬梅,苏海辉,张颖,李莉莉,孙颖,罗庆录.更昔洛韦治疗带状疱疹多中心开放研究[J].中国皮肤性病学杂志,2006,20(9):538-539. 被引量:24
  • 9[9]Darenkov IA,Marcarelli MA,Basadonna GP,et al.Reduced incidence of Epstein-Barr virus-associated posttransplant lymphoproliferative disorder using preemptive antiviral therapy.Transplantation,1997,64:848-852. 被引量:1
  • 10[10]Alrabiah FA,Sacks SL.New antiherpesvirus agents.Their targets and therapeutic potential.Drugs,1996,52:17-32. 被引量:1

二级参考文献34

  • 1丁海,赵伟,端木浩,易永祥,俞建光,刘俊卯,袁受涛.肝移植病人带状疱疹感染1例的治疗体会[J].肝胆外科杂志,2005,13(3):239-240. 被引量:3
  • 2Karakayali H,Emiroglu R,Arslan G,et al.Major infectious complications after kidney transplantation.Transplant Proc,2001,33:1816-1817. 被引量:1
  • 3Hogewoning AA,Goettsch W,Van Loveren H,et al.Skin infections in renal transplant recipients.Clin Transplant,2001,15:32-38. 被引量:1
  • 4Whitley RJ,Gnann JW.Acyclovir:a decade later.N Engl J Med,1992,327:782. 被引量:1
  • 5Cesaro T,File LT,Rayhan S,et al.Cutaneous dissemination of herpes simplex virus in individuals fifteen years and older[J].Am J med Sci,1977,273 (3):343-353. 被引量:1
  • 6American Academy of Pediatrics.Section 3.Summaries of Infectious Diseases.In:Pickering LK,Baker CJ,Long SS,et al,eds.Red Book:2006 Report of the Committee on Infectious Diseases.27th ed.Elk Grove Village,IL:American Academy of Pediatrics,2006.711-725. 被引量:1
  • 7Hambleton S,Gershon AA.Preventing varicella-zoster disease.Clin Microbio Rev,2005,18(1):70-80. 被引量:1
  • 8Grant RM,Weitzman SS,Sherman CG,et al.Fulminant disseminated varicella zoster virus infection without skin involvement.J Clin Virol,2002,24(1-2):7-12. 被引量:1
  • 9Stratman E.Visceral zoster as the presenting feature of disseminated herpes zoster.J Am Acad Dermatol,2002,46(5):771-774. 被引量:1
  • 10Koren G,Money D,Boucher M,et al.Serum concentrations,efficacy,and safety of a new,intravenously administered varicella zoster immune globulin in pregnant women.J Clin Pharmacol,2002,42(3):267-274. 被引量:1

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