Discussion on varicella-zoster virus infection after solid organ transplantation
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摘要: 实体器官移植术后的相关感染是移植科医师在移植受体术后管理中所面临的重大挑战之一, 也是影响器官移植受体术后恢复的重要因素。水痘-带状疱疹病毒(VZV)在正常人群中有较高的感染率, 但其发病往往是亚临床、自愈性的。而在实体器官移植受体中, 其临床症状表现明显, 可导致受体生活质量降低、再入院率及经济压力增加、甚至影响移植物功能, 严重时可导致死亡。本文回顾国内外相关文献, 就VZV感染的流行病学特点及其发病风险因素, 器官移植后VZV感染的临床表现、诊断、治疗及预防做一综述, 以期为临床工作提供参考。
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表 1 VZV的实验室检测方法
Table 1. Laboratory testing methods of VZV
检测方法 优点 缺点 灵敏度 直接抗体荧光检测 快速、病毒特异性较高 灵敏度较低、需要细胞染色 82% VZV病毒PCR检测 灵敏度较高、各种标本均可检测 检测费用较高、检测技术要求高 95% 血清病毒培养 可检测病毒亚群、能够同时检测药物敏感性 培养耗时长、标本的储存及运输会影响结果 20% Tzanck涂片检查 快速、直接、可视 需要在新鲜病灶中取材、技术要求高、不能与疱疹病毒区别 低 病理学活组织检查 明确组织病变 有创操作、耗时长 48% 血清学检测 术前检测可明确移植术后感染风险 移植术后无检测意义 无 -
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