摘要
目的研究膦甲酸钠（ＰＦＡ）治疗肾移植术后巨细胞病毒（ＣＭＶ）感染的疗效与毒副作用。方法随机选取肾移植术后４１例ＣＭＶ感染活动期（１１例有明显临床症状）和２２例静止期患者使用ＰＦＡ，另选１０例静止期病例不予处理作为对照。活动期治疗ＰＦＡ用量为４０ｍｇ／ｋｇ，静止期治疗ＰＦＡ用量为５０ｍｇ／ｋｇ，前者２～３周、后者３～４周为１疗程。结果无症状的活动期病例ＰＦＡ平均使用１２．６２天后血清学结果转阴；有临床症状的１１例中，应用１４天后１０例显效，另１例治疗３７天后血清学结果转阴，随访３个月无复发；静止期治疗组用药后观察３个半月，均未发现ＣＭＶ活动感染；对照组１０例中有３例分别于随访１个月、２个月、３个月时发生ＣＭＶ活动性感染。ＰＦＡ的毒副反应：所有治疗者中仅１例出现一过性尿量减少、肾功能可逆性改变，２例出现皮肤潮红反应，血钙及环孢素Ａ的代谢无变化。结论ＰＦＡ可快速控制ＣＭＶ感染，疗效确切而显著，随访期内无复发；静止期患者使用ＰＦＡ与否，随访期内血清学的检查结果差异显著；ＰＦＡ对移植肾功能无明显损害，不干扰血钙及环孢素Ａ的代谢，是一安全而有效的治疗ＣＭＶ感染的药物。
Objective To study the therapeutic effects and side effects of foscarnet in the treatment of active (IgG+, IgM+) and inactive (IgG+, IgM-) cytomegalovirus(CMV) infection after cadaver renal transplantation.Methods Forty one cases of active cytomegalovirus infection and 22 of inactive cytomegalovirus were selected to receive foscarnet treatment. Besides, 10 cases of inactive cytomegalovirus infection served as control group without receiving foscarnet. The usage of foscarnet was 40mg/kg, iv., 2～3 weeks in the active stage, 50mg/kg, iv., 3～4 weeks in the inactive stage. Results Clinical symptoms of patients in the active stage were controlled, and serologic CMV IgG turned negative. Moreover, no positive infection was found after 3 month follow up for those who received foscarnet. At the same time, 3 patients in the control group turned into active infection. Only one receiving foscarnet appeared urine volume cutting down temporarily, and the renal function had a reversible change; 2 patients had skin red reaction.Conclusion Foscarnet could control CMV active infection quickly, markedly and firmly, and no recurrence was found during a 3 month follow up. Foscarnet may protect the inactive patients from turning positive. And foscarnet had no obvious damage to the renal graft function and didn't interfere with the metabolism of blood calcium and cyclosporine A. Foscarnet is a safe and effective drug to treat CMV infection.
出处
《中华器官移植杂志》
CAS
CSCD
1999年第1期37-39,共3页
Chinese Journal of Organ Transplantation
