肾移植术后感染性腹泻的诊疗分析
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摘要
肾移植是挽救晚期慢性肾衰竭患者的最佳方式,与长期透析比较可使患者获得更长久的生存率,但由于术后需要长期服用免疫抑制剂和相对较长时间的抗生素,极易容易引起肠道菌群紊乱和肠道感染,导致腹泻的发生。本文着重回顾了有关肾移植受者感染性腹泻的现有文献,对肾移植后感染性腹泻的研究进展进行了总结,并希望为临床能寻找到高效可靠的移植后感染性腹泻的评估方法提供一定的思路。
Kidney transplantation is the best way to save patients with advanced chronic renal failure, it can help patients achieve a longer survival rate rather than long-term dialysis, but it is easy to cause long-term use of immunosuppressive agents and relatively long-term antibiotics. Intestinal flora disorder and intestinal infection, leading to diarrhea. This article focuses on the existing literature on infectious diarrhea in renal transplant recipients, summarizes the research progress of infectious diarrhea after renal transplantation, and hopes to provide an effective and reliable evaluation method for infectious diarrhea after transplantation. Certain ideas.
Kidney transplantation is the best way to save patients with advanced chronic renal failure, it can help patients achieve a longer survival rate rather than long-term dialysis, but it is easy to cause long-term use of immunosuppressive agents and relatively long-term antibiotics. Intestinal flora disorder and intestinal infection, leading to diarrhea. This article focuses on the existing literature on infectious diarrhea in renal transplant recipients, summarizes the research progress of infectious diarrhea after renal transplantation, and hopes to provide an effective and reliable evaluation method for infectious diarrhea after transplantation. Certain ideas.
引文
[1]李智斌,张更,刘克普,等.肾移植术后慢性腹泻的临床诊治分析[J].器官移植,2015(3):184-189.
[2]Bunnapradist S,Neri L,Wong W,et al.Incidence and risk factors for diarrhea following kidney transplantation and association with graft loss and mortality[J].Am J Kidney Dis,2008,51(3):478-486.
[3]Pant C,Deshpande A,Larson A,et al.Diarrhea in solid-organ transplant Recipients:a review of the evidence[J].Curr Med Res Opin,2013,29(10):1315-1328.
[4]Moos S,CippàPE,Wüthrich RP,et al.Intestinal infection at onset of mycophenolic acid-associated chronic diarrhea in kidney transplant recipients[J].Transplant Infectious Disease,2016,18(5):721-729.
[5]孙雯,郭宏波,解泽林,等.肾移植患者术后腹泻的相关因素分析[J].北京大学学报(医学版),2013,45(5):779-781.
[6]廖巧红,冉陆,靳淼,等.诺如病毒感染暴发调查和预防控制技术指南(2015版)[J].中国病毒病杂志,2015(6):7-16.
[7]侯军,薛武军,田普训,等.肾移植术后患者腹泻的原因和治疗[C].//2012中国器官移植大会论文集,2012:143-144.
[8]潘秀珍.诺如病毒相关研究进展[J].医学研究生学报,2015(3):225-228.
[9]康一生,于立新.器官移植后巨细胞病毒耐药的处理[J].器官移植,2017,8(1):73-77.
[10]Linares L,Sanclemente G,Cervera C,et al.Influence of cytomegalovirus disease in outcome of solid organ transplant patients[J].Transplantation Proceedings,2011,43(6):2145-2148.
[11]Stelzmueller I,Wiesmayr S,Swenson BR,et al.Rotavirus enteritis in solid organ transplant recipients:an underestimated problem?[J].Transplant Infectious Disease,2010,9(4):281-285.
[12]Ison MG.Adenovirus Infections in Transplant Recipients[J].Clinical Infectious Diseases,2006,43(3):331-339.
[13]Hsu JL,Enser JJ,Mckown T,et al.Outcomes of Clostridium difficile infection in recipients of solid abdominal organ transplants[J].Clinical Transplantation,2014,28(2):267-273.
[14]Pant C,Anderson MP,O'Connor JA,et al.Association of Clostridium difficile infection with outcomes of hospitalized solid organ transplant recipients:results from the 2009 Nationwide Inpatient Sample database[J].Transplant Infectious Disease,2012,14(5):540-547.
[15]陈小丽,万珊珊,曹倩.炎症性肠病住院患者216例的难辨梭状芽孢杆菌感染危险因素和预后[J].中华消化杂志,2017,37(4):238-243.
[16]Durand CM,Marr KA,Arnold CA,et al.Detection of Cytomegalovirus DNA in Plasma as an Adjunct Diagnostic for Gastrointestinal Tract Disease in Kidney and Liver Transplant Recipients[J].Clinical Infectious Diseases,2013,57(11):1550-1559.
[17]赵奇,廖贵益.肾移植术后巨细胞病毒感染的诊断与防治进展[J].器官移植,2014(6):392-395.
[18]Dunbar SA,Zhang H,Tang YW.Advanced techniques for detection and identification of microbial agents of gastroenteritis[J].Clinics in Laboratory Medicine,2013,33(3):527-552.
[19]于海.1163例腹泻患儿粪便中轮状病毒抗原检测结果分析[J].临床医药文献电子杂志,2018,5(89):52-53.
[20]Florescu DF,Hoffman JA.Adenovirus in solid organ transplantation.Am J Transplant 2013,13(Suppl 4):206-211.
[21]杨麦贵,杨铮,杨阳,等.蠊缨滴虫感染的诊断和治疗[J].国际检验医学杂志,2014(3):311-313.
[22]王垒,黄康,彭贵主,等.肾移植术后巨细胞病毒感染的预防[J].武汉大学学报(医学版),2017,38(6):916-919.
[23]Patel MM,Hall AJ,Vinje J,Parashar UD.Noroviruses:a comprehensive review[J].J Clin Virol 2009(44):1-8.
[24]孔翔羽,靳淼,段招军.诺如病毒与食源性疾病[J].中国临床医生杂志,2015(7):21-23.
[25]陈锦荣,Yih WK.美国婴儿接种轮状病毒疫苗的肠套叠风险[J].微生物学免疫学进展,2015(3):57.
[2]Bunnapradist S,Neri L,Wong W,et al.Incidence and risk factors for diarrhea following kidney transplantation and association with graft loss and mortality[J].Am J Kidney Dis,2008,51(3):478-486.
[3]Pant C,Deshpande A,Larson A,et al.Diarrhea in solid-organ transplant Recipients:a review of the evidence[J].Curr Med Res Opin,2013,29(10):1315-1328.
[4]Moos S,CippàPE,Wüthrich RP,et al.Intestinal infection at onset of mycophenolic acid-associated chronic diarrhea in kidney transplant recipients[J].Transplant Infectious Disease,2016,18(5):721-729.
[5]孙雯,郭宏波,解泽林,等.肾移植患者术后腹泻的相关因素分析[J].北京大学学报(医学版),2013,45(5):779-781.
[6]廖巧红,冉陆,靳淼,等.诺如病毒感染暴发调查和预防控制技术指南(2015版)[J].中国病毒病杂志,2015(6):7-16.
[7]侯军,薛武军,田普训,等.肾移植术后患者腹泻的原因和治疗[C].//2012中国器官移植大会论文集,2012:143-144.
[8]潘秀珍.诺如病毒相关研究进展[J].医学研究生学报,2015(3):225-228.
[9]康一生,于立新.器官移植后巨细胞病毒耐药的处理[J].器官移植,2017,8(1):73-77.
[10]Linares L,Sanclemente G,Cervera C,et al.Influence of cytomegalovirus disease in outcome of solid organ transplant patients[J].Transplantation Proceedings,2011,43(6):2145-2148.
[11]Stelzmueller I,Wiesmayr S,Swenson BR,et al.Rotavirus enteritis in solid organ transplant recipients:an underestimated problem?[J].Transplant Infectious Disease,2010,9(4):281-285.
[12]Ison MG.Adenovirus Infections in Transplant Recipients[J].Clinical Infectious Diseases,2006,43(3):331-339.
[13]Hsu JL,Enser JJ,Mckown T,et al.Outcomes of Clostridium difficile infection in recipients of solid abdominal organ transplants[J].Clinical Transplantation,2014,28(2):267-273.
[14]Pant C,Anderson MP,O'Connor JA,et al.Association of Clostridium difficile infection with outcomes of hospitalized solid organ transplant recipients:results from the 2009 Nationwide Inpatient Sample database[J].Transplant Infectious Disease,2012,14(5):540-547.
[15]陈小丽,万珊珊,曹倩.炎症性肠病住院患者216例的难辨梭状芽孢杆菌感染危险因素和预后[J].中华消化杂志,2017,37(4):238-243.
[16]Durand CM,Marr KA,Arnold CA,et al.Detection of Cytomegalovirus DNA in Plasma as an Adjunct Diagnostic for Gastrointestinal Tract Disease in Kidney and Liver Transplant Recipients[J].Clinical Infectious Diseases,2013,57(11):1550-1559.
[17]赵奇,廖贵益.肾移植术后巨细胞病毒感染的诊断与防治进展[J].器官移植,2014(6):392-395.
[18]Dunbar SA,Zhang H,Tang YW.Advanced techniques for detection and identification of microbial agents of gastroenteritis[J].Clinics in Laboratory Medicine,2013,33(3):527-552.
[19]于海.1163例腹泻患儿粪便中轮状病毒抗原检测结果分析[J].临床医药文献电子杂志,2018,5(89):52-53.
[20]Florescu DF,Hoffman JA.Adenovirus in solid organ transplantation.Am J Transplant 2013,13(Suppl 4):206-211.
[21]杨麦贵,杨铮,杨阳,等.蠊缨滴虫感染的诊断和治疗[J].国际检验医学杂志,2014(3):311-313.
[22]王垒,黄康,彭贵主,等.肾移植术后巨细胞病毒感染的预防[J].武汉大学学报(医学版),2017,38(6):916-919.
[23]Patel MM,Hall AJ,Vinje J,Parashar UD.Noroviruses:a comprehensive review[J].J Clin Virol 2009(44):1-8.
[24]孔翔羽,靳淼,段招军.诺如病毒与食源性疾病[J].中国临床医生杂志,2015(7):21-23.
[25]陈锦荣,Yih WK.美国婴儿接种轮状病毒疫苗的肠套叠风险[J].微生物学免疫学进展,2015(3):57.