Montoya J G, Giraldo L F, Efron B, Stinson E B, Gamberg P, Hunt S, Giannetti N, Miller J, Remington J S
Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, Palo Alto, California 94301, USA.
Clin Infect Dis. 2001 Sep 1;33(5):629-40. doi: 10.1086/322733. Epub 2001 Aug 6.
A total of 1073 infectious episodes (IEs) that occurred in 620 consecutive heart transplantation patients at Stanford Medical Center between 16 December 1980 and 30 June 1996 were reviewed. Infectious complications were a major cause of morbidity and mortality, second only to rejection as the cause of early deaths and the most common cause of late deaths. Of the IEs, 468 (43.6%) were caused by bacteria, 447 (41.7%) by viruses, 109 (10.2%) by fungi, 43 (4.0%) by Pneumocystis carinii, and 6 (0.6%) by protozoa. The largest number of IEs occurred in the lungs (301 [28.1%]). A significant reduction in the incidence of IEs and a delay in presentation after transplantation were observed; these were most likely related to the introduction of new chemoprophylactic regimens during the study period and prevention of significant disease caused by cytomegalovirus.
回顾了1980年12月16日至1996年6月30日期间斯坦福医疗中心620例连续心脏移植患者发生的共计1073次感染发作（IEs）。感染并发症是发病和死亡的主要原因，作为早期死亡原因仅次于排斥反应，且是晚期死亡的最常见原因。在这些感染发作中，468次（43.6%）由细菌引起，447次（41.7%）由病毒引起，109次（10.2%）由真菌引起，43次（4.0%）由卡氏肺孢子虫引起，6次（0.6%）由原生动物引起。感染发作次数最多的部位是肺部（301次[28.1%]）。观察到感染发作的发生率显著降低以及移植后发病延迟；这很可能与研究期间引入新的化学预防方案以及预防巨细胞病毒引起的严重疾病有关。
