肾移植术后并发结核感染的诊断及治疗经验

为了探讨肾移植术后并发结核感染的发生原因，诊断及治疗经验，观察了１１例肾移植术后并发结核感染的患者，结果为治愈６例，摘除移植肾４例，死亡１例。认为：（１）肾移植术后患者由于细胞免疫功能低下及接受抗排斥的免疫抑制剂，结核感染的发生率是一般人群的５０倍。（２）肾移植术后高热应用抗生素效果不佳者即使化验结果阴性也不能排除结核菌感染。（３）一旦确立诊断早期使用抗结核药物，同时将激素减为最低量。（４）对药物

Diagnosis and treatment of tuberculosis following kidney transplantation

In order to investigate the pathogenesis, diagnosis and treatment of tuberculosis following kidney transplantation, 11 tuberculosis patients after renal transplantation were studied. The results showed that 6 were cured , 4 were extirpated the graft, and one died. It was believed that: Because of the immunosuppressant use and cellular immune hopofunction, the morbidity of tuberculosis after kidney transplantation is 50 times of that of the normal. The patients with high fever after kidney transplantation who had no efficiency to antibiotic should be suspected tuberculosis even if the patients had negative examination results. Antibuterculotic should be used as early as possible when the diagnosis was confirmed and the prednisone should be extenuated to minimum. The patient with low efficiency to antibuberculotic should stop taking immunosuppressants and the renal graft extirpated.