摘要
目的探讨肾移植受者继发新型冠状病毒(COVID-19)感染免疫抑制方案的调整。方法总结疫情初期本中心收治的5例肾移植术后继发COVID-19感染病人的临床资料,分析其免疫抑制剂的应用特点。结果1例普通型病人,免疫抑制方案未做调整;4例重型/危重型病人,霉酚酸酯平均停用(19.8±3.6)天,他克莫司先减半量(8.3±4.1)天,因症状未能控制再完全停用(9.0±3.1)天,同时静脉使用20~40 mg/d甲泼尼龙,平均(11.8±4.2)天。5例病人均核酸转阴,肾功能正常,康复出院,从发病到出院平均(37.6±8.3)天。结论对于肾移植术后继发COVID-19感染,尤其重型/危重型病人,免疫抑制剂减量甚至停用以及早期小剂量短疗程应用皮质类固醇对于疾病的控制至关重要。
Objective To investigate the management of immunosuppression in kidney transplant recipients with COVID-19.Methods Retrospective,five cases of kidney transplant recipients with confirmed COVID-19;all the medical history,clinical features and the management of immunosuppression were recorded and analyzed.Results The immunosuppression regimen was not adjusted in 1 common type patient.4 cases were severe/critical,while the mycophenolate mofetil was discontinued for(19.8±3.6)d in the other 4 severe/critical cases;tacrolimus was taken at half dosage for(8.3±4.1)d and complete discontinuation for(9.0±3.1)d due to uncontrolled symptoms.At the same time,20~40 mg/d methylprednisolone was given intravenously for(11.8±4.2)d.All the 5 patients had negative nucleic acid and normal renal function,and were discharged from hospital.The mean time from onset to discharge was(37.6±8.3)d.Conclusion For kidney transplant patients with COVID-19,especially those with severe pneumonia,reducing or withdrawal of immunosuppressive agents,as well as early low-dose and short-term use of corticosteroids,are essential for good outcomes.
作者
黄倩
陈松
刘斌
卢峡
朱兰
昌盛
陈知水
明长生
张伟杰
HUANG Qian;CHEN Song;LIU Bin(Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《临床外科杂志》
2021年第4期385-387,共3页
Journal of Clinical Surgery
基金
湖北省卫生健康委员会重点支持项目(WJ2019Z007)。
关键词
新型冠状病毒
肾移植
免疫抑制剂
皮质类固醇
coronavirus disease 2019
kidney transplant
immunosuppressants
corticosteroids
