肾移植术后免疫球蛋白预防肺部感染疗效观察.pdfVIP

肾移植术后免疫球蛋白预防肺部感染 疗效观察 【摘要】 目的：探讨肾移植术后监测T 淋巴细胞亚群变化，予用免疫球蛋白 预防肺部感染的临床意义。方法：收集 2007 年 1 月～2009 年 6 月肾移植手术患者 资料，监测 30 例肾移植术后 T 淋巴细胞亚群变化，根据其变化分为正常组 18 例及 治疗组 12 例，治疗组用免疫球蛋白 0.2g・kg-1・d-1×3d 治疗，观察两组肺部感染 发生率，肾功能及 T 淋巴细胞亚群变化。结果：T 淋巴细胞亚群水平正常组相对稳 定，治疗组降低。正常组与治疗组普通肺炎和重症肺炎发生率差异无统计学意义 (P0.05);治疗前 T 淋巴细胞水平治疗组低于正常组 (P0.05)，而治疗组治疗后较 治疗前 T 淋巴细胞水平明显上升 (P0.05)。结论：根据肾移植术后T 淋巴细胞水平 变化，早期使用免疫球蛋白治疗，能减少肺部感染发生，减少并发症，及早恢复机 体免疫功能，提高生存率。 【关键词】肾移植;T淋巴细胞;肺部感染 [ABSTRACT] Objective: To elucidate the clinical value of using immunoglobulin to prevent pulmonary infection by monitor the T lymphocyte levels in patients after renal transplantation. Methods: A total of 30 cases with renal transplantation were selected from January 2007 to June 2009， the change of T lymphocyte subsets were measured after renal transplantation， according to the change， 18 cases were pided into control group， others were into treatment group. The patients were given with immunoglobulin 0.2g・kg-1・d-1×3d in treatment group. The incidence of pulmonary infection， renal function and T lymphocyte subsets were observed. Results: T lymphocyte subsets were lower in treatment group than that of control group. The incidence of common pneumonia and severe pneumonia showed no significant difference between control group and treatment group (P0.05); T lymphocyte level was lower in treatment group (P0.05) before treatment than that of control group， and significantly increased in patients treated with immunoglobulin (P0.05). Conclusion: Treating with immunoglobulin according to T lymphocyte levels in early stage of post��renal transplantation patients can reduce lung infections and complications， recover immune function in time and improve survival rate. [KEY WORDS] Renal transplantation; T lymphocytes; Pulmonary infection 肾移植术后早期并发症主要是感染，尤其是肺部感染特别是重症肺炎(包 括巨细胞肺炎)，病情进展迅速，治疗十分困难，预后差[1]。如果在发病之前，预 先采取预防措施，是否能降低发病率，值得探讨。我院对肾移植术患者在没有发生