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中华肾病研究电子杂志 ›› 2020, Vol. 09 ›› Issue (01) : 1 -6. doi: 10.3877/cma.j.issn.2095-3216.2020.01.001

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慢性肾脏病合并感染的诊断与防治
毛永辉1,(), 王海涛1   
  1. 1. 100730 北京,北京医院肾内科 国家老年医学中心 中国医学科学院老年医学研究院
  • 收稿日期:2020-01-30 出版日期:2020-02-28
  • 通信作者: 毛永辉

Diagnosis, treatment and prevention of infection in chronic kidney disease

Yonghui Mao1,(), Haitao Wang1   

  1. 1. Department of Nephrology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine of Chinese Acadamy of Medical Sciences, Beijing 100730, China
  • Received:2020-01-30 Published:2020-02-28
  • Corresponding author: Yonghui Mao
  • About author:
    Corresponding author: Mao Yonghui, Email:
引用本文:

毛永辉, 王海涛. 慢性肾脏病合并感染的诊断与防治[J/OL]. 中华肾病研究电子杂志, 2020, 09(01): 1-6.

Yonghui Mao, Haitao Wang. Diagnosis, treatment and prevention of infection in chronic kidney disease[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2020, 09(01): 1-6.

伴随免疫抑制药物的应用及肾小球滤过率(GFR)下降,慢性肾脏病(CKD)患者可出现固有免疫和适应性免疫缺陷,导致感染性疾病高发并成为各阶段CKD患者住院和死亡的第二大原因。肺部和血流感染是CKD患者最主要的两种感染形式。不同的免疫缺陷状态对不同病原体的易感性不尽相同,诊治成功的关键在于快速明确感染部位及微生物学诊断,尽早开始病原学治疗。本文介绍了CKD常见特殊病原体(肺孢子菌、巨细胞病毒、奴卡菌及结核分枝杆菌)感染的临床特点、诊断方法、治疗及预防策略。对于免疫抑制状态下的CKD患者,临床随访过程中注意密切监测外周血淋巴细胞计数,警惕机会性感染的发生。

With the use of immunosuppressive drugs and the decline in glomerular filtration rate (GFR), patients with chronic kidney disease (CKD) can develop innate and adaptive immune deficiency, leading to a high incidence of infectious diseases which has become the second leading cause of hospitalization and death among individuals with CKD at all stages. Pulmonary and bloodstream infections are the two most common forms of infection in patients with CKD. Different immune deficiency statuses have different susceptibility to different pathogens. It is important to identify the site and etiology of infection quickly and initiate the etiological treatment as early as possible. This paper introduced the clinical characteristics, diagnosis methods, treatment and prevention strategies of infections with common special pathogens (pneumocystis, cytomegalovirus, nocardia and mycobacterium tuberculosis) in CKD. For CKD patients under immunosuppressive conditions, close attention should paid to monitoring peripheral blood lymphocyte counts during clinical follow-up to keep alert to the occurrence of opportunistic infections.

表1 免疫缺陷状态与感染类型
表2 肾功能不全常用抗结核药物调整
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