首页|Omicron 变异株激增时期肾移植受者感染Omicron 变异株患者临床特征分析

Omicron 变异株激增时期肾移植受者感染Omicron 变异株患者临床特征分析

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目的 报道和分析肾移植受者(KTRs)合并新型冠状病毒(SARS-CoV-2)Omicron变异株感染患者的临床特征并探究影响血肌酐变化的可能因素.方法 回顾性观察2022年10月至2023年12月于该院行同种异体肾移植术且合并Omicron变异株感染的患者,收集并分析其临床资料、基础合并症及预后情况等,分析影响血肌酐变化的可能因素.结果 本研究纳入的114例KTRs合并Omicron变异株感染的患者中,居家管理组(A组)90例(78.9%)、非重症隔离病房组(B组)18例(15.8%)、ICU组(C组)6例(5.3%),出现最多的症状依次是发热(90.4%)、乏力(65.8%)和咳嗽(61.4%),临床表现以上呼吸道感染症状为主,整体病死率为2.6%(3/114),且死亡患者均为C组患者.C组基础合并症数量较B组及A组更高(P<0.05).患者再分为肌酐升高组(D组)33例(28.9%),肌酐不变组(E组)71例(62.3%),肌酐下降组(F组)10例(8.8%),F组均为Omicron变异株感染轻型和中型的A组患者,D组和F组较E组都有更大比例的患者停用或减量钙调神经磷酸酶抑制剂类药物.结论 Omicron变异株对KTRs的危害性较前其他变异株已大幅下降,实现抗感染与抗排斥间的免疫平衡是预防KTRs肾功能损害的有效措施.
Analysis on clinical characteristics of kidney transplant recipients with Omicron variant infection
Objective To report and analyze the clinical characteristics of kidney transplant recipients(KTRs)combined with novel coronavirus Omicron variant strain infection of novel coronavirus(SARS-CoV-2),and to investigate the possible factors affecting the serum creatinine change.Methods The patients under-going allogeneic kidney transplantation and complicating Omicron variant strain infection in this hospital from October 2022 to December 2023 were retrospectively observed.Their clinical data,basic complications and prognosis,etc.were collected and analyzed.The possible factors affecting the serum creatinine change were an-alyzed.Results Among the 114 cases of KTRs combined with Omicron variant strain infection included in this study,there were 90 cases(78.9%)in the home management group(group A),18 cases(15.8%)in the non-intensive isolation ward group(group B)and 6 cases(5.3%)in the ICU group(group C).The most common symptoms were in turn fever(90.4%),fatigue(65.8%)and cough(61.4%),the clinical manifesta-tions were mainly upper respiratory tract infection symptoms.The overall mortality rate was 2.6%(3/114),moreover the dead patients all were in the group C.The number of basic comorbidities in the group C was higher than that in the group B and group A(P<0.05).The patients were re-divided into 33 cases(28.9%)in the creatinine increase group(group D),71 cases(62.3%)in the creatinine unchange group(group E)and 10 cases(8.8%)in the creatinine decrease group(group F).The patients in the F group were the patients with mild and moderate Omicron variant strain infection in the group A,and a larger proportions of the pa-tients in the group D and group F discontinued or reduced the calcineurin inhibitor(CNI)type drugs than in the group E.Conclusion The hazard of Omicron variant strains to KTRs has been greatly reduced compared with previous other variant strains.Realizing the immune balance between anti-infection and anti-rejection is the effective measure for preventing renal function damage in KTRs.

SARS-CoV-2Omicron variant strainkidney transplantserum creatininecomplications

吴凯军、陈代晖、李茂、梁思敏

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重庆医科大学附属第一医院泌尿外科,重庆 400016

新型冠状病毒 Omicron变异株 肾移植 血肌酐 合并症

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(13)
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