Kidney Transplantation, Postoperative Active Cmv Infection And 23 Cases Of Clinical Retrospective Analysis

1 Objective:This research retrospectively analyse the diagnosis and treatment of active Cytomegalovirus(CMV) infection in 23 allograft renal transplanted patients and try to provide new thoughts for the diagnosis and treatment of active Cytomegalovirus infection in allograft renal transplanted patients.2 Method: This research collect 23 patients who got the active Cytomegalovirus infection after renal transplantation and defining the research areas in the first day on admission and one month after,also making 3 days,one week,two weeks,three weeks,one month after admission as the observation points to research the diagnosis and treatment of active Cytomegalovirus infection in allograft renal transplanted patients. Statistics take SPASS13.0 software dealing with the data, mainly choose frequency, percentage, standard deviation of sample means X2 test and so on.3 Result:3.1 Retrospecting the symptoms of 23 patients who got the active Cytomegalovirus infectionFever, hypodynamia got the most frequency and percentage when they on admission.And then the frequency and percentage decreased after two week's treatment.Also chest distress, dyspnea, X-ray : interstitial pneumonia became to appear after 3 days on admission,and came to the peak a week after admission.They began to decrease after 2 weeks'treatment,and decreased obviously after 3 weeks'treatment.3.2 Retrospection of the CMV-IgM and CMV-PP65 antigenOnly 13 patients'CMV-IgM was positive when they admission and after a week 19 patients'CMV-IgM was positive,18 patients'was strong positive among them.23 patients'CMV-PP65 antigen was positive when they admission,and 20 patients'was high titer.The result almost same when a week after admission. It has difference between CMV-IgM and CMV-PP65 antigen when they admission.3.3 Retrospection of the treatment and the curative effectBased on the patients'specific conditions, treated with anti-virus, Changed the project of the immunosuppressant.Also provided others treatment such as nutritional support, assisted respiration, immunity enhancement,CRRT, preventing superinfection and so on. Results 18 cases were cured,3 cases'was effective, and inefficacy in 2 cases. 8 cases were cured of CMV pneumonia, 3 cases'was effective, and inefficacy in 2 cases.4 Conclusion(1) Fever and hypodynamia was the mainly earlier symptom of the active Cytomegalovirus infection.And for the patients of CMV pneumonia, the symptom of dry cough without phlegm could appear in early stage.The symptom of chest distress, dyspnea, X-ray:interstitial pneumonia mainly appeared after pathogenesis two weeks.(2)PP65 antigen is superior to CMV-IgM in early diagnosis and sensitivity of active Cytomegalovirus infection.(3)For the treatment of active Cytomegalovirus infection in allograft renal transplanted patients, anti-virus and changed the project of the immunosuppressant is the chief treatment measure.The patients who get the severe infection can use the treatment of CRRT and thymopentin.(4)Early treatment of CMV pneumonia is important, including anti-virus, changed the project of the immunosuppressant, nutritional support and so on.And assisted respiration is the key for the patients who complicated with ARDS.