中国组织工程研究Issue(2)：262-266,5.DOI:10.3969/j.issn.2095-4344.2015.02.019
肾移植后肺部感染治疗中免疫抑制剂的应用
Immunosuppressant therapy for pulmonary infection after kidney transplantation
杨其顺 1张琳 1张志强 1姜伟 1龙伟 1裴向克1
作者信息
- 1. 解放军第281医院肾脏移植中心，河北省秦皇岛市 066100
- 折叠
摘要
Abstract
BACKGROUND:Pulmonary infection after kidney transplantation evolves rapidly. There is a high mortality rate in patients with server pulmonary infection. It has the important significance of early diagnosis and treatment of pulmonary infection, but some patients appear to have impaired kidney function because of the adjustment of immunosuppressants. OBJECTIVE:To explore the approaches to applying the immunosuppressants during the treatment of pulmonary infection after kidney transplantation. METHODS:The clinical data of 85 kidney transplantation patients who suffered from pulmonary infection were retrospectively analyzed. There were 43 cases in which the infection occurred within 1-6 months after kidney transplantation, 39 of which within 2-4 months; 7 cases of infection occurring within 6-12 months; 7 cases of infection within 12-24 months; 6 cases of infection within 24-36 months; 22 cases of infection occurring beyond 36 months. The immunosuppressant dose was adjusted based on a per-case basis. As a complement, the smal-dose hormone was used for anti-inflammation. Etiological treatments for resisting infections were also conducted accordingly. Ventilators were utilized for patients with respiratory failures. The body temperature of patients was monitored and controled. Appropriate nutrition support was also provided accordingly. There were 44 cases of decreasing or stopping the use of immunosuppressants during the early period of pulmonary infection; 19 cases of decreasing or stopping the use of immunosuppressants during the treatment of pulmonary infection;5 cases of stopping the use of immunosuppressants during the period of severe pneumonia; 15 cases of gradualy changing the dose of immunosuppressants during the early and progressive period of pneumonia; 2 cases of decreasing the use during the early period of pneumonia and stopping the use during the period of severe pneumonia. The duration of decreasing or stopping the use of immunosuppressants ranged from 3-51 days, with an average of 10.7 days. RESULTS AND CONCLUSION: Among the 85 patients, there were 81 cases cured and 4 cases of death. Among the four death cases, two cases died of acute respiratory failure and two cases died of multiple organ failure. Of the cured 81 cases, acute rejection occurred in 3 cases, while renal alograft dysfunction occurred in 6 cases. Decreasing or temporarily stopping the use of immunosuppressants during the treatment of pulmonary infection caused by the kidney transplantation increases the cure rate and decreases the mortality rate; while timely resuming the usage of immunosuppressants effectively protects the renal graft function, especialy for patients with renal graft dysfunction.关键词
组织构建/组织工程/肾移植/肺部感染/免疫抑制剂Key words
Kidney Transplantation/Lung/Infection/Immunosuppressive-Agents分类
医药卫生引用本文复制引用
杨其顺,张琳,张志强,姜伟,龙伟,裴向克..肾移植后肺部感染治疗中免疫抑制剂的应用[J].中国组织工程研究,2015,(2):262-266,5.
