肾移植后早期受者BK病毒DNA拷贝数的影响因素研究
A quantitative analysis of factors affecting BK viral DNA loads in early renal transplant recipients
摘要目的 探讨肾移植后早期受者BK病毒的负荷状况及其影响因素.方法 检测80例同种异体肾移植受者血清和尿液中的BK病毒DNA拷贝数,并且分析肾移植临床常见的参数对BK病毒负荷的影响.结果 80例中,BK病毒血症阳性者为7例(占8.75%),BK病毒尿症阳性者为30例(占37.5%).>50岁组受者血清和尿液中BK病毒DNA拷贝数都明显高于≤50岁组(P<0.05);他克莫司组血清BK病毒DNA拷贝数高于环孢素A(CsA)组(P<0.05),前组受者血清BK病毒负荷高峰时间在术后14个月,而后者在术后10个月.两组尿液BK病毒负荷高峰时间提前,Tac组为术后2个月,CsA组为术后8个月.结论 年龄>50岁、正在服用他克莫司可能为BK病毒再次激活及BK病毒肾病的高危因素.
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abstractsObjective To investigate DNA loads and risk factors of BK virus infection in renal transplant recipients.Methods We developed a real-time PCR assay to quantitate BK virus loads in 80 patients receiving renal transplantation in our center,and correlation between the BK virus load and clinical course was analyzed.BK virus loads were measured in urine and plasma. Epidemiological features and risk factors of BK virus infection were analyzed.Results The positive rate of BKV viruria and viremia in 80 renal recipients was 37.5% (30/80) and 8.75% (7/80),respectively.BKV loads were higher in renal allograft recipients whose age was more than 50 years old.BKV loads were observed in urine and plasma (compared with group whose age was less than 50 years,P=0.017 and 0.05,respectively).BKV DNA copies were higher in group Tac than that in group CSA (P<0.05),and the peak of BKV load in serum appeared at14th and10th month after transplantation,respectively,but the peak in urine was ahead of that in serum,appeared at 2nd and 8th month,respectively.Conclusion Serial measurement of BKV viral loads by quantitative PCR is a useful tool in monitoring the course of BK virus infection.The ages of recipients (>50 years) and using Tac + MPA can reactivate BK virus and then result in BKVAN in renal transplant recipients. Intensive BKV monitoring is necessary for these recipients.
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