中文摘要：

目的探讨肾移植术后间质性肺炎的早期诊断、预防及处理原则。方法选择吉林大学第一医院泌尿系统疾病诊治中心2008年至2011年肾移植术后出现间质性肺炎患者83例。比较2008年1-12月与2009年1月-2011年12月两个时期肾移植患者术后预防及治疗的差异，以及间质性肺炎的发生情况。结果2008年1-12月138例患者进行肾移植，术后发生间质性肺炎38例，发生率为27.54%；2009-2011年435例患者行肾移植，45例术后发生间质性肺炎，发生率为10.34%。2008年组肾移植术后患者早期住院期间给予静脉注射更昔洛韦针剂，出院后口服更昔洛韦片剂及复方新诺明片剂。2009-2011年组肾移植术后患者出院后根据患者血药浓度及血肌酐水平给予口服更昔洛韦片剂及复方新诺明片剂。在患者检查肺部CT确诊为间质性肺炎后入院，2008年组采取根据患者的病情减少或停用免疫抑制剂，给予适量糖皮质激素冲击、更昔洛韦抗病毒及联合复方新诺明抗原虫治疗；2009-2011年组则采取根据患者的病情情况使用规律性大剂量糖皮质激素冲击，并停用免疫抑制剂，同时抗病毒及联合复方新诺明抗原虫治疗。2008年组治愈/好转35例，死亡2例，1例放弃治疗，治疗期间发生排异反应3例。2009-2011年组治愈/好转45例，死亡0例，治疗期间发生排异反应3例。2008-2011年573例肾移植术患者中，接受巴利昔单抗或抗胸腺细胞球蛋白（ATG）等抗体诱导治疗183例，未接受抗体诱导治疗390例；在83例肾移植术后发生间质性肺炎患者中，有27例患者应用巴利昔单抗或ATG等抗体诱导治疗，其余56例未接受抗体诱导治疗。结论①早期停用免疫抑制剂、给予糖皮质激素冲击治疗、更昔洛韦抗巨细胞病毒治疗、联合应用复方新诺明抗原虫治疗及有效的营养支持是治疗肾移植术后治疗间质性肺炎的有力措施。②在有效的肾移植?

英文摘要：

Objective To investigate the early diagnosis,prophylaxis and treatment principles of interstitial pneumonia in renal transplant recipients. Methods 83 kidney transplant recipients who diagnosed with interstitial pneumonia during the period from 2008 to 2011 in the Urinary Diseases Diagnosis&Treatment Center, First Hospital of Jilin University were enrolled in this study. The difference of prophylaxis,treatment with interstitial pneumonia and the occurrence of interstitial pneumonia after renal transplantation between January - December, 2008 and January 2009-December 2011 were compared. Results There were a total of 138 patients underwent allograft renal transplantation during the period from January 2008 to December 2008,and 38 of the kidney recipients developed interstitial pneumonia and the incidence rate was 27.54%. There were a total of 435 patients underwent allograft renal transplantation during the period from January 2009 to December 2011,and 45 of the kidney recipients developed interstitial pneumonia and the incidence rate was 10.34%. Kidney transplant recipients during the period from January 2008 to December 2008 received intravenous ganciclovir during the hospital stay and oral ganciclovir in the post-discharge period. Kidney transplant recipients during the period from January 2009 to December 2011 received oral ganciclovir and trimethoprim-sulfamethoxazole(SMZ-TMP)in the post-discharge period according to the plasma concentration and the level of serum creatinine. When diagnosed with interstitial pneumonia by pulmonary CT,the immunosuppressive drugs of the recipients during the period from January 2008 to December 2008 were reduced or withdrew,and corticosteroid therapy,ganciclovir resistant cytomegalovirus(CMV)treatment, combination with the cotrimoxazole antiprotozoal treatment were given. The recipients during the period from January 2009 to December 2011 were received regular high-dose corticosteroid and withdrew the immunosuppressive drugs, given ganciclovir resistant CMV treatment with combi