肝移植术后结核病临床特征分析

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Abstract Objective To summarize and analyze the clinical features of mycobacterium tuberculosis (MTB) infection in liver transplant recipients.Methods The clinical data of 44 patients with post-transplant tuberculosis in the 8th Medical Center of PLA General Hospital from April 2009 to April 2021 were retrospectively reviewed, and the clinical manifestations, laboratory results,imaging features, treatment and prognosis were descriptively analyzed.Results The mean age of the patients was (53.95±9.15) years. The most frequently reported symptoms at diagnosis were fever(52.3%), followed by cough(50%) and expectoration(36.4%). The median time between liver transplant and TB diagnosis was 24(10.00,59.25) months, and 14 cases(31.8%) occurred during the first post-transplant year. Secondary pulmonary tuberculosis (68.2%)was the most common, and 27.3% patients had two or more tuberculosis types. The incidence of extra-pulmonary and disseminated tuberculosis was 25% and 15.9%, respectively. The positive rates of PPD test, blood tuberculosis antibody and interferon-gamma release assays are 47.4%,75%, 67.7% respectively. The positive rate of blood tuberculosis antibody was significantly higher than that of PPD test(χ²=4.39,P=0.04). 56.8% of the patients underwent invasive examination, and the positive rate was 92%. The number of people definitely diagnosed with invasive methods was significantly higher than that with non-invasive methods(χ²=15.14,P<0.01). 11 patients (25%)had impaired liver function throughout the course of treatment, and the total effective rate of treatment was 90.9%.Conclusions Tuberculosis is most common after liver transplantation within 2 years. Early diagnosis of tuberculosis after liver transplantation is difficult and the misdiagnosis rate is high, so more attention should be paid to tuberculosis in patients with recurrent pulmonary infection after liver transplantation. Suspected cases should receive diagnostic therapy timely, and invasive examination is helpful in diagnosis.

Key words： liver transplantation tuberculosis diagnosis interferon-gamma release assays

Received: 18 January 2022

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	FENG Likui
	WANG Ruiguan
	DU Guosheng

Cite this article:

FENG Likui,WANG Ruiguan,DU Guosheng. Clinical features of tuberculosis after liver transplantation[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2022, 33(6): 480-483.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2022/V33/I6/480

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