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目的探讨肾移植术后肺结核感染的早期诊断和治疗。方法回顾性分析12例肾移植术后肺结核感染患者的临床资料。均采取免疫抑制剂减量或停用,加大糖皮质激素剂量,异烟肼+利福平+乙胺丁醇或吡嗪酰胺三联抗结核疗法,辅以营养支持治疗。结果12例患者均在1个月左右症状缓解出院,并常规抗结核6～15个月后痊愈。结论胸部X线、痰涂片或培养、PPD、血Anti-TBAb及PCR等综合检测,结合临床表现是早期诊断的关键。调整免疫抑制方案,增加糖皮质激素用量,果断采取抗结核治疗以及营养支持治疗,将有助改善患者的预后。
Objective To investigate the early diagnosis and treatment of pulmonary tuberculosis after renal transplantation. Methods The clinical data of 12 patients with tuberculosis after kidney transplantation were retrospectively analyzed. Adopt immunosuppressive agents to reduce or disable, increase glucocorticoid dose, isoniazid + rifampicin + ethambutol or pyrazinamide triple anti-TB therapy, supplemented by nutritional support treatment. Results All 12 patients were relieved and relieved at about one month and were cured after routine anti-TB treatment for 6-15 months. Conclusion The combined detection of chest X-ray, sputum smear or culture, PPD, blood Anti-TBAb and PCR combined with clinical manifestations is the key to early diagnosis. Adjusting the immunosuppressive regimen, increasing the amount of glucocorticoid, decisive TB and nutritional support therapy will help to improve the patient’s prognosis.