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目的探讨缬更昔洛韦是否能够有效预防肺移植术后巨细胞病毒(CMV)感染。方法回顾性分析2015年9月-2017年4月河南省人民医院胸外科收治的11例肺移植患者的临床资料,其中双肺移植1例,单肺移植10例。根据术前CMV血清学IgG、IgM检测、HCMV-DNA检测及供体肺血清学检测患者分为高危、中危及低危患者,本中心患者均为CMV感染中危者,术后3个月内口服缬更昔洛韦900 mg/d,其余药物常规服用。常规定期监测血常规、肝肾功能、感染指标、肺功能及胸部CT。结果共纳入11例手术,男性9例,女性2例;平均年龄(43.5±13.1)岁;其中原发病为COPD呼吸衰竭1例,矽肺6例,弥漫性肺大疱1例,肺间质纤维化3例。术后2例随访丢失,9例定期监测CMV抗体、白细胞及血小板等指标,随访至今未发现CMV感染迹象。结论肺移植术后口服缬更昔洛韦3个月能够有效预防CMV感染,有助于降低术后并发症。
Objective To investigate whether valganciclovir can effectively prevent cytomegalovirus (CMV) infection after lung transplantation. Methods The clinical data of 11 patients who underwent lung transplantation from September 2015 to April 2017 in Henan Provincial People’s Hospital were retrospectively analyzed. Among them, 1 patient had lung transplantation and 10 patients had single lung transplantation. According to the preoperative CMV serology IgG, IgM test, HCMV-DNA test and donor lung serology test, the patients were divided into high risk, intermediate risk and low risk patients. The patients in this center were both CMV infected critically ill. Within 3 months after operation, Oral valganciclovir 900 mg / d, other drugs routinely take. Routine regular monitoring of blood, liver and kidney function, infection, lung function and chest CT. Results A total of 11 cases were enrolled in this study. There were 9 males and 2 females, with an average age of (43.5 ± 13.1) years. The primary disease was COPD respiratory failure in 1 case, silicosis in 6 cases, diffuse bullae in 1 case, 3 cases of fibrosis. Two patients were lost after follow-up. Nine patients were regularly monitored for CMV antibodies, white blood cells and platelets, and no signs of CMV infection were observed up to now. Conclusion Oral valganciclovir 3 months after lung transplantation can effectively prevent CMV infection and reduce postoperative complications.