Methylprednisolone therapy for severe pulmonary infection after kidney transplantation
10.3969/j.issn.2095-4344.2014.05.015
- VernacularTitle:甲泼尼龙治疗肾移植后的重症肺部感染
- Author:
Xing WEI
;
Ming CAI
;
Zhouli LI
;
Hailong JIN
;
Xin HONG
;
Changqing CHEN
;
Bingyi SHI
- Publication Type:Journal Article
- Keywords:
organ transplantation;
kidney transplantation;
pneumonia;
methylprednisolone;
blood gas analysis
- From:
Chinese Journal of Tissue Engineering Research
2014;(5):742-747
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Pulmonary infection is the main complication after kidney transplantation, and its onset and morbidity may be related to conventional oral drugs after kidney transplantation.
OBJECTIVE:To analyze the effect of methylprednisolone instead of prednisone on severe pulmonary infection after kidney transplantation.
METHODS:Clinical data of 58 patients with severe pulmonary infection after kidney transplantation were retrospectively analyzed. First, according to the characteristics of post-onset patients and lung CT findings, broad-spectrum antibiotics and anti-fungal treatment were adopted, and subsequently targeted therapy, that is, withdrawal or adjustment of dosage and combination regimen of immunosuppressive agents, was employed depending on etiology, fungi and virus detection results. Among the 58 patients, 28 patients were injected methylprednisolone, and 30 patients took oral prednisone. Hyoxemia correction, support therapy and immune replacement therapy were applied.
RESULTS AND CONCLUSION:Thirty-nine of 58 patients (67.2%) were positive for pathogens, including 7 cases of simple bacterial pneumonia, 4 cases of fungal pneumonia, 3 cases of simple cytomegalovirus infection, and 25 cases of mixed infections (5 cases of multiple bacterial infections, 17 cases of fungal and bacterial co-infections, and 3 cases of fungi, bacteria and cytomegalovirus co-infections). Patients subjected to methylprednisolone treatment spent shorter time to recover their temperature than those undergoing oral prednisone (P<0.05). In addition, creatinine fluctuation range in the methylprednisolone group was less than that in the prednisone group (P<0.05). The results showed that intravenous injection of methylprednisolone may accelerate absorption of inflammatory exudate in the lung and shorten treatment time.
