肾移植病人巨细胞病毒感染的防治进展(3)
5.小结
CMV感染是器官移植领域中一个常见而危害严重的问题，目前临床所用药物的疗效还不能令人满意，预防与治疗用药的方案尚未统一，已有研究资料所用的判断标准、用药方案也不一致，难以对其结果进行比较。因此，寻找疗效更加可靠的药物，制定合理的治疗方案仍是目前需要进一步进行研究的内容。国外已有一些新的药物和剂型如Cidofovir (HPMPC)、lobucovir (环丁基鸟苷，Cyclobutyl-guaovosine)及更昔洛韦口服剂型的开发，应用于临床后可能对CMV感染的治疗有一定改进。
参考文献
1. Dunn DI，Najarian JS，New approaches to the diagnosis，prevention and treatment for Cytomegalovirus infection after transplantion. Am J Surg, 1991;161:25.
, http://www.100md.com
2. The Tricontinental Mycophenylate Mofetil Renal Transplantation Study Group: A blinded, randomized clinical trial of mycophenylate mofetil for the prevention of acute rejection in cadaveric renal transplantation. Transplantation 61:11029-1037,1996.
3. Ho M, Miller G, Atchison RW et al. Epstein -Barr virus intections and DNA hybridization studied in posttransplantation lymphoma and lymphoproliferstive lesions: the role of primary infection. J Infect Bis, 1985;153:876.
, 百拇医药
4. Cole nH, Balfour HH: In vitro susceptibility of cytomegalovirus isolates from immunocompromised patients to acyclovir and ganciclovir.Diagn Microbiol Infect Dis 6:255-261,1987.
5. Balfour HH Jr, Chace BA,Stapelton JT, Simmons RL, Fryd DS:A randomized, placebo-controlled trial of oral acyclovir for the prevention of cytomegalovirus disease in recipients of renal allografts. N Engl J Med 320:1381-1387,1989.
6. Dunn DL, Gillingham KJ, Kramer MA, Schmidt WJ, Erice A,Balfour HHJ, Gores PF, Gruessner PW, Matas AJ, Payne WD, Sutherland DER, Najarian JS: A prospective randomized study of acyclovir versusganciclovir plus human immune globulin prophylaxis of cytomegalovirus infection after solid organ transplantation. Transplantation 57:876-884.1994.
, http://www.100md.com
7. Hibberd pL, Tolkoff-Rubin NE,Conti D,Stuart F, Thistlethwaite JR, Neylan JF, Snydman DR, Freeman R, Lorber MI, Rubin RH:Preemptive ganciclovir therapy to prevent cytomegalovirus disease in cytomegalovirus antibody-positive reanl transplant recipients: A randomized controlled trial.Ann Intern Med 123:18-26,1995.
8. Conti DJ, Freed BM, Singh TP, Gallichio M, Gruber SA, Lempert N:Preemptive gancicilovir therapy in cytomegalovirus-seropositive renal transplants rcipins, Arch Surg 130:1217-1221.1995.
, 百拇医药
9. Winston DJ, Wirin D,Shaked A, Busuttil RW:Randomised comparison of ganciclovir and high-dose acyclovir for long-term cytomegalovirus prophlaxis in liver-transplant recipients.Lancet 346:69-74,1995.
10. MacDonald PS, Keogh AM, Marshman D,Richens D, Harvison A,Kaan AM,Spratt PM: A double-Blind Placebo-controlled trial of low-dose ganciclovir to prevent cytomegalovirus disease after heart transplantation. J Heart Lung Transplant 14:32-38,1995.
, http://www.100md.com
11. Neumayer HH, Kreis H,Squifflet JP: Efficacy and safety of valaciclovir for suppression of cytomegalovirus disease in recipients of a cadaveric renal allograft [Abstract]. Presentd at the 37th Interscinence Conference on Antimicrobial Agents and Chemotherapy, September 28 to October 1,1997.
12. 徐达 王祥慧等 膦甲酸钠治疗与预防肾移植后巨细胞病毒感染的临床研究.肾脏病与透析肾移植杂志,1998;7(6):526。
13. Rondrau E,Peraldi MN,Kanfer A,et al.Treatment of cytomegalovirus infections in renal transplants.Nephrology, 1991,12:189-192.
, http://www.100md.com
14. Sarbjit VJ,Janet MR,et al Clinical Practice Guidelires:Prevention of Cytomegalovirus Disease after Renal Transploantation, JASN, 1998,9:1697-1708.
15. Brennan DC, Garlock KA, Lippmann BJ,Buller RS, Gaudreault-Keener M, Lowell JA, Miller SB, Shenoy S, Howard TK,Storch GA:Control of cytomegaolvirus-associated morbidity in tenal transplant patients using intenxive monitoring and either preemptive or diferred therapy.J Am Soc Nephrol 8:118-125,1997.
, 百拇医药
16. Duncan SR, Grgurich WF, Iacono AT,Burckart GJ, Yousem SA,Paradis IL, Williams PA, Johnson BA< Griffith BP: A comparison of ganciclovir and acyclovir to prevent cytomegalovirus after lung transplantation. Am J Respir Crit Care Med 150:146-152,1994.
17. Martin M, Manez R,Linder P, Estores D, Torre-Cisneros J, Kusne S, Ondick L, Ptachcinski R, Irish W, Kisor D,Relsner I, Rinaldo C, Stieber A, Fung J, Ho MA: A prospective randomized trial comparing sequential ganciclovir-high dose acyclovir to high dose acyclovir for prevention of cytomegalovirus disease in adult liver transplant recipients. Transplantation 58:779-785,1994.
18. Martin M: Combination protocols for prevention of CMV disease in the high risk transplant patient. Transplant Prco 28[Suppl2]:12-13,1996., 百拇医药(王世相)
CMV感染是器官移植领域中一个常见而危害严重的问题，目前临床所用药物的疗效还不能令人满意，预防与治疗用药的方案尚未统一，已有研究资料所用的判断标准、用药方案也不一致，难以对其结果进行比较。因此，寻找疗效更加可靠的药物，制定合理的治疗方案仍是目前需要进一步进行研究的内容。国外已有一些新的药物和剂型如Cidofovir (HPMPC)、lobucovir (环丁基鸟苷，Cyclobutyl-guaovosine)及更昔洛韦口服剂型的开发，应用于临床后可能对CMV感染的治疗有一定改进。
参考文献
1. Dunn DI，Najarian JS，New approaches to the diagnosis，prevention and treatment for Cytomegalovirus infection after transplantion. Am J Surg, 1991;161:25.
, http://www.100md.com
2. The Tricontinental Mycophenylate Mofetil Renal Transplantation Study Group: A blinded, randomized clinical trial of mycophenylate mofetil for the prevention of acute rejection in cadaveric renal transplantation. Transplantation 61:11029-1037,1996.
3. Ho M, Miller G, Atchison RW et al. Epstein -Barr virus intections and DNA hybridization studied in posttransplantation lymphoma and lymphoproliferstive lesions: the role of primary infection. J Infect Bis, 1985;153:876.
, 百拇医药
4. Cole nH, Balfour HH: In vitro susceptibility of cytomegalovirus isolates from immunocompromised patients to acyclovir and ganciclovir.Diagn Microbiol Infect Dis 6:255-261,1987.
5. Balfour HH Jr, Chace BA,Stapelton JT, Simmons RL, Fryd DS:A randomized, placebo-controlled trial of oral acyclovir for the prevention of cytomegalovirus disease in recipients of renal allografts. N Engl J Med 320:1381-1387,1989.
6. Dunn DL, Gillingham KJ, Kramer MA, Schmidt WJ, Erice A,Balfour HHJ, Gores PF, Gruessner PW, Matas AJ, Payne WD, Sutherland DER, Najarian JS: A prospective randomized study of acyclovir versusganciclovir plus human immune globulin prophylaxis of cytomegalovirus infection after solid organ transplantation. Transplantation 57:876-884.1994.
, http://www.100md.com
7. Hibberd pL, Tolkoff-Rubin NE,Conti D,Stuart F, Thistlethwaite JR, Neylan JF, Snydman DR, Freeman R, Lorber MI, Rubin RH:Preemptive ganciclovir therapy to prevent cytomegalovirus disease in cytomegalovirus antibody-positive reanl transplant recipients: A randomized controlled trial.Ann Intern Med 123:18-26,1995.
8. Conti DJ, Freed BM, Singh TP, Gallichio M, Gruber SA, Lempert N:Preemptive gancicilovir therapy in cytomegalovirus-seropositive renal transplants rcipins, Arch Surg 130:1217-1221.1995.
, 百拇医药
9. Winston DJ, Wirin D,Shaked A, Busuttil RW:Randomised comparison of ganciclovir and high-dose acyclovir for long-term cytomegalovirus prophlaxis in liver-transplant recipients.Lancet 346:69-74,1995.
10. MacDonald PS, Keogh AM, Marshman D,Richens D, Harvison A,Kaan AM,Spratt PM: A double-Blind Placebo-controlled trial of low-dose ganciclovir to prevent cytomegalovirus disease after heart transplantation. J Heart Lung Transplant 14:32-38,1995.
, http://www.100md.com
11. Neumayer HH, Kreis H,Squifflet JP: Efficacy and safety of valaciclovir for suppression of cytomegalovirus disease in recipients of a cadaveric renal allograft [Abstract]. Presentd at the 37th Interscinence Conference on Antimicrobial Agents and Chemotherapy, September 28 to October 1,1997.
12. 徐达 王祥慧等 膦甲酸钠治疗与预防肾移植后巨细胞病毒感染的临床研究.肾脏病与透析肾移植杂志,1998;7(6):526。
13. Rondrau E,Peraldi MN,Kanfer A,et al.Treatment of cytomegalovirus infections in renal transplants.Nephrology, 1991,12:189-192.
, http://www.100md.com
14. Sarbjit VJ,Janet MR,et al Clinical Practice Guidelires:Prevention of Cytomegalovirus Disease after Renal Transploantation, JASN, 1998,9:1697-1708.
15. Brennan DC, Garlock KA, Lippmann BJ,Buller RS, Gaudreault-Keener M, Lowell JA, Miller SB, Shenoy S, Howard TK,Storch GA:Control of cytomegaolvirus-associated morbidity in tenal transplant patients using intenxive monitoring and either preemptive or diferred therapy.J Am Soc Nephrol 8:118-125,1997.
, 百拇医药
16. Duncan SR, Grgurich WF, Iacono AT,Burckart GJ, Yousem SA,Paradis IL, Williams PA, Johnson BA< Griffith BP: A comparison of ganciclovir and acyclovir to prevent cytomegalovirus after lung transplantation. Am J Respir Crit Care Med 150:146-152,1994.
17. Martin M, Manez R,Linder P, Estores D, Torre-Cisneros J, Kusne S, Ondick L, Ptachcinski R, Irish W, Kisor D,Relsner I, Rinaldo C, Stieber A, Fung J, Ho MA: A prospective randomized trial comparing sequential ganciclovir-high dose acyclovir to high dose acyclovir for prevention of cytomegalovirus disease in adult liver transplant recipients. Transplantation 58:779-785,1994.
18. Martin M: Combination protocols for prevention of CMV disease in the high risk transplant patient. Transplant Prco 28[Suppl2]:12-13,1996., 百拇医药(王世相)