Biocina B, Husedzinović I, Sutlić Z, Presecki V, Wallwork J
Department of Cardiac Surgery, Clinic of Surgery, Clinical Hospital Dubrava, Zagreb, Croatia.
Coll Antropol. 1999 Dec;23(2):673-81.
A group of 284 patients who underwent orthotopic heart transplantation between April 1986 to June 1991 and who were followed up for at least five years was analyzed in this paper. Patients were divided into three groups according to the presence or absence of cytomegalovirus infection or disease: patients without infection, patients with serologycaly proven infection and patients with cytomegalovirus disease. The analysis of survival was performed with respect to all major factors that influence survival: age and sex of a donor and a recipient, number of rejection episodes, perioperative ischemic time and pulmonary vascular resistence. A recipient's age was shown to be a significant factor. Patients who experienced at least one episode of cytomegalovirus disease had significantly worse long-term survival compared to those with the infection only or without the infection. That difference was caused by the increased incidence of coronary atherosclerosis, which caused deaths in patients with a previous episode of cytomegalovirus disease. A possible mechanism responsible for this phenomenon is discussed.
本文分析了1986年4月至1991年6月间接受原位心脏移植且至少随访五年的284例患者。根据是否存在巨细胞病毒感染或疾病，将患者分为三组：未感染患者、血清学证实感染患者和患有巨细胞病毒疾病患者。针对所有影响生存的主要因素进行了生存分析：供体和受体的年龄及性别、排斥反应发作次数、围手术期缺血时间和肺血管阻力。结果显示受体年龄是一个重要因素。与仅感染或未感染的患者相比，经历至少一次巨细胞病毒疾病发作的患者长期生存率明显更差。这种差异是由冠状动脉粥样硬化发病率增加所致，冠状动脉粥样硬化导致曾有巨细胞病毒疾病发作的患者死亡。本文还讨论了导致这一现象的可能机制。
