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疫情常态化防控期间不规律随访对肾移植术后BK病毒再激活时的病毒载量及受者预后影响

吴周庭, 王於尘, 曾文利, 等. 疫情常态化防控期间不规律随访对肾移植术后BK病毒再激活时的病毒载量及受者预后影响[J]. 器官移植, 2024, 15(3): 429-434. doi: 10.3969/j.issn.1674-7445.2023231
引用本文: 吴周庭, 王於尘, 曾文利, 等. 疫情常态化防控期间不规律随访对肾移植术后BK病毒再激活时的病毒载量及受者预后影响[J]. 器官移植, 2024, 15(3): 429-434. doi: 10.3969/j.issn.1674-7445.2023231
Wu Zhouting, Wang Yuchen, Zeng Wenli, et al. Effect of irregular follow-up during normalized prevention and control of epidemic on viral load upon BK virus reactivation and prognosis of kidney transplant recipients[J]. ORGAN TRANSPLANTATION, 2024, 15(3): 429-434. doi: 10.3969/j.issn.1674-7445.2023231
Citation: Wu Zhouting, Wang Yuchen, Zeng Wenli, et al. Effect of irregular follow-up during normalized prevention and control of epidemic on viral load upon BK virus reactivation and prognosis of kidney transplant recipients[J]. ORGAN TRANSPLANTATION, 2024, 15(3): 429-434. doi: 10.3969/j.issn.1674-7445.2023231

疫情常态化防控期间不规律随访对肾移植术后BK病毒再激活时的病毒载量及受者预后影响

doi: 10.3969/j.issn.1674-7445.2023231
基金项目: 国家自然科学基金(82270784、82070770);广东省基础与应用基础研究基金(2023A1515012276);广东省学位与研究生教育创新计划项目(2022JDXM031)
详细信息
    作者简介:
    通讯作者:

    苗芸(ORCID 0000-0003-3592-4695),博士,主任医师,研究方向为肾移植,Email:miaoyunecho@126.com

  • 中图分类号: R617, R373

Effect of irregular follow-up during normalized prevention and control of epidemic on viral load upon BK virus reactivation and prognosis of kidney transplant recipients

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  • 摘要:   目的  探讨在新型冠状病毒肺炎疫情常态化防控期间不规律随访对肾移植受者术后BK病毒(BKV)再激活情况及预后的影响。  方法  回顾性分析363例肾移植受者的临床资料,按随访时间分为疫情前随访组与疫情期间随访组,随访期限为1年。比较疫情前随访组和疫情期间随访组的随访时间间隔,分析两组BKV感染情况,分析BKV感染进程与移植肾功能的相关性。  结果  疫情前随访共计1 790例次,疫情期间随访共计2 680例次。与疫情期间随访组比较,疫情前随访组术后3个月内、3~6个月、7~12个月的随访时间间隔较短,差异均有统计学意义(均为P<0.05)。在肾移植术后1年内,疫情前随访组35例(32%)检出BKV尿症、3例(3%)检出BKV血症、1例(1%)检出BKV相关肾病(BKVAN),疫情期间随访组53例(25%)检出BKV尿症、3例(1%)检出BKV血症、1例(1%)检出BKVAN,差异均无统计学意义(均为P>0.05)。疫情前随访组术后首次检出BKV尿症时间长于疫情期间随访组,首次再激活尿BKV载量小于疫情期间随访组,差异均有统计学意义(均为P<0.05)。首次再激活尿BKV载量与尿BKV载量峰值,BKV再激活后第1、3个月血清肌酐与基线血清肌酐差值呈正相关(均为P<0.05)。  结论  肾移植术后不规律随访可导致BKV再激活时间提前、首次尿BKV载量检出值更高,以及延迟诊断和干预,并造成不良预后。亟待建立远程随访体系以满足发生公共卫生事件时肾移植受者的随访需求。

     

  • 图  1  首次再激活时尿BKV载量与移植肾功能的相关性分析

    注:A图为尿BKV载量峰值与首次再激活尿BKV载量的相关性;B图为BKV再激活后第1个月血清肌酐与基线血清肌酐差值与首次再激活尿BKV载量的相关性;C图为BKV再激活后第3个月血清肌酐与基线血清肌酐差值与首次再激活尿BKV载量的相关性。

    Figure  1.  Correlation analysis between urinary BKV load at first reactivation and transplant kidney function

    表  1  术后12个月内疫情前随访组与疫情期间随访组随访间隔的比较($\overline {\boldsymbol{x}} $±s,d)

    Table  1.   Comparison of follow-up intervals between the pre-epidemic follow-up group and the during-epidemic follow-up group within 12 months after surgery

    分组 例次 术后随访间隔
    3个月内 3~6个月 7~12个月
    疫情前随访组 1 790 10±5 23±9 30±12
    疫情期间随访组 2 680 11±6 24±10 32±16
    P 0.010 0.028 0.048
    下载: 导出CSV
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  • 收稿日期:  2023-12-18
  • 网络出版日期:  2024-03-07
  • 刊出日期:  2024-05-15

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