Vilchez Regis, McCurry Kenneth, Dauber James, Iacono Aldo, Keenan Robert, Griffith Bartley, Kusne Shimon
Department of Medicine, University of Pittsburgh Medical Center, and Thomas E. Starzl Transplantation Institute, Pittsburgh, Pennsylvania 15213, USA.
Transplantation. 2002 Apr 15;73(7):1075-8. doi: 10.1097/00007890-200204150-00010.
Although influenza and parainfluenza viruses commonly cause respiratory tract infections in the community, their incidence and clinical implications in adult lung transplant recipients have received little attention.
We performed a retrospective cohort study of influenza and parainfluenza viral infections in adult lung transplant recipients at the University of Pittsburgh Medical Center.
Between January 1989 and March 1999, 39 cases (single-lung 25, double-lung 14) of influenza or parainfluenza respiratory viral infection were identified at a mean of 1.7 years (SD+/-1.4) after transplantation. The mean length of admission was 7 days. The cases included 15 patients with influenza (A, 11; B, 4) and 24 with parainfluenza (para1, 7; para2, 2; para3, 15). The median age at diagnosis was 48 years; there were 19 females and 20 males. Symptoms were reported in 30 patients and lasted for a median of 7 days before admission. These included cough (64%), shortness of breath (56%), and temperature elevation (33%). Chest infiltrates were seen in 14 (36%) patients, and 5 (13%) of them required intubation and mechanical ventilation. Viral pneumonia was diagnosed in 10 (5 influenza and 5 parainfluenza) patients, and concurrent bacterial pneumonia occurred in 4 patients. Transbronchial biopsy was performed in 36 patients, of whom 23 (64%) showed some degree of acute allograft rejection.
Influenza and parainfluenza respiratory viral infections are associated with significant morbidity in adult lung transplant recipients. Active vaccination programs and the development of new antiviral agents active against these viruses are important for prevention.
尽管流感病毒和副流感病毒通常会引起社区呼吸道感染，但它们在成年肺移植受者中的发病率及临床意义却很少受到关注。
我们对匹兹堡大学医学中心成年肺移植受者的流感和副流感病毒感染情况进行了一项回顾性队列研究。
在1989年1月至1999年3月期间，共确诊了39例（单肺移植25例，双肺移植14例）流感或副流感呼吸道病毒感染病例，这些病例发生在移植后的平均1.7年（标准差±1.4）。平均住院时间为7天。病例包括15例流感患者（甲型11例，乙型4例）和24例副流感患者（1型7例，2型2例，3型15例）。诊断时的中位年龄为48岁；女性19例，男性20例。30例患者报告了症状，入院前症状持续的中位时间为7天。这些症状包括咳嗽（64%）、呼吸急促（56%）和体温升高（33%）。14例（36%）患者出现胸部浸润，其中5例（13%）需要插管和机械通气。10例（5例流感和5例副流感）患者被诊断为病毒性肺炎，4例患者并发细菌性肺炎。36例患者进行了经支气管活检，其中23例（64%）显示有一定程度的急性移植物排斥反应。
流感和副流感呼吸道病毒感染在成年肺移植受者中与显著的发病率相关。积极的疫苗接种计划以及开发对这些病毒有效的新型抗病毒药物对于预防至关重要。
