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目的探讨肾移植术后远期急性排斥反应与巨细胞病毒感染的关系。方法检测４５例移植肾有功能存活１年以上后发生急性排斥反应者外周血白细胞中巨细胞病毒ＤＮＡ（ＣＭＶＤＮＡ），并给予激素冲击治疗，对激素冲击无效的部分患者给予更昔洛韦抗病毒治疗。结果３２例激素冲击有效，１３例无效。无效者外周血白细胞内可测到ＣＭＶＤＮＡ，８例用更昔洛韦治疗后ＣＭＶＤＮＡ转阴，２例肾功能好转，６例恢复正常，另５例未用更昔洛韦者ＣＭＶＤＮＡ持续阳性，肾功能损害加重。结论部分肾移植受者发生的远期急性排斥反应与ＣＭＶ感染有一定关系；临床上对用激素冲击治疗无效的远期急性排斥可给予抗病毒治疗
Objective To investigate the relationship between long-term acute rejection and cytomegalovirus infection after renal transplantation. Methods Cytomegalovirus DNA (CMVDNA) in peripheral blood leukocytes from 45 patients with functional graft after more than one year of functional survival of renal allografts was measured and treated with hormonal shock. Some patients with inactive side effects of ganciclovir were given antiviral activity of ganciclovir treatment. Results 32 cases of hormone shock effective, 13 cases ineffective. CMVDNA was detected in the peripheral blood leukocytes of the inactive patients, negative of CMVDNA in 8 patients treated with ganciclovir, improvement of renal function in 2 patients, normal of 6 patients, positive of CMVDNA in 5 patients without ganciclovir, Functional impairment worsened. Conclusions The long-term acute rejection occurred in some renal transplant recipients has a certain relationship with CMV infection. Antiviral therapy may be given to the long-term acute rejection that is not effective in the treatment of hormonal shock