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目的总结肾移植术后并发结核感染的临床诊断与治疗经验。方法对11例该类患者进行回顾性分析。依据患者的临床表现、实验室检查、胸片、病理检查及对抗结核治疗的阳性反应确定诊断,即合理应用多种抗结核药。结果8例治愈并保持肾功能正常,摘除移植肾、移植肾失功转入血液透析及死亡各1例。结论肾移植术后机体免疫功能低下,容易并发结核感染。对肾移植术后出现不明原因的发热或常规抗感染治疗无效,即使无任何微生物和/或病理的支持,也应高度怀疑结核感染,并尽早应用抗结核治疗。
Objective To summarize the clinical diagnosis and treatment experience of tuberculosis infection after renal transplantation. Methods 11 cases of these patients were retrospectively analyzed. According to the patient’s clinical manifestations, laboratory tests, chest X-ray, pathological examination and anti-tuberculosis treatment positive response to determine the diagnosis, that is, rational use of a variety of anti-TB drugs. Results 8 cases were cured and maintained normal renal function, removal of allograft kidneys, transplanted kidney failure into hemodialysis and death in 1 case. Conclusions After renal transplantation, immune function is poor and it is easy to be infected with tuberculosis. For unknown causes of fever or routine anti-infective therapy after renal transplantation, TB infection should be highly suspected even without any support of micro-organisms and / or pathology and anti-TB treatment should be applied as soon as possible.