Abstract：
Nephropathy due to BK virus infection is a major cause of graft dysfunction and loss. No specific treatment has been developed for the BK virus. Here, we compared the combination of intravenous immunoglobulin and leflunomide versus intravenous immunoglobulin to treat BK virus nephropathy after renal transplant.
This study was a randomized controlled clinical trial. Sixteen kidney transplant patients with BK virus infection were randomly divided into 2 groups; 1 group received intravenous immunoglobulin, and another group received leflunomide and intravenous immunoglobulin. P < .05 was considered statistically significant.
Results of a polymerase chain reaction test for BK virus after 2 months of treatment were negative in 3 patients in the intravenous immunoglobulin group and in 7 patients in the intravenous immunoglobulin + leflunomide group. The amount of BK virus decreased significantly in each group, and a significant difference was observed between the 2 groups after 3 months (P = .014). The average level of creatinine in the intravenous immunoglobulin group at 1, 2, and 3 months after treatment was 1.7 ± 0.23, 1.8 ± 0.5, and 1.5 ± 0.3, respectively, and in the intravenous immunoglobulin + leflunomide group was 2.1 ± 0.75, 1.76 ± 0.37, and 1.4 ± 0.18, respectively (P > .05).
Although BK viral load decreased significantly in both groups, there was a significant difference between patients who received intravenous immunoglobulin versus those who received the combination of intravenous immunoglobulin + leflunomide after 3 months. The addition of leflunomide to the intravenous immunoglobulin treatment seems to have a better effect in reducing BK viral load. However, further studies with a larger sample and longer duration are needed.
This study was a randomized controlled clinical trial. Sixteen kidney transplant patients with BK virus infection were randomly divided into 2 groups; 1 group received intravenous immunoglobulin, and another group received leflunomide and intravenous immunoglobulin. P < .05 was considered statistically significant.
Results of a polymerase chain reaction test for BK virus after 2 months of treatment were negative in 3 patients in the intravenous immunoglobulin group and in 7 patients in the intravenous immunoglobulin + leflunomide group. The amount of BK virus decreased significantly in each group, and a significant difference was observed between the 2 groups after 3 months (P = .014). The average level of creatinine in the intravenous immunoglobulin group at 1, 2, and 3 months after treatment was 1.7 ± 0.23, 1.8 ± 0.5, and 1.5 ± 0.3, respectively, and in the intravenous immunoglobulin + leflunomide group was 2.1 ± 0.75, 1.76 ± 0.37, and 1.4 ± 0.18, respectively (P > .05).
Although BK viral load decreased significantly in both groups, there was a significant difference between patients who received intravenous immunoglobulin versus those who received the combination of intravenous immunoglobulin + leflunomide after 3 months. The addition of leflunomide to the intravenous immunoglobulin treatment seems to have a better effect in reducing BK viral load. However, further studies with a larger sample and longer duration are needed.
摘要：
目的：BK病毒感染引起的肾病是移植物功能障碍和丢失的主要原因。尚未开发针对BK病毒的特异性治疗方法。这里,我们比较了静脉注射免疫球蛋白和来氟米特与静脉注射免疫球蛋白联合治疗肾移植后BK病毒肾病的疗效.
方法：本研究为随机对照临床试验。将16例BK病毒感染的肾移植患者随机分为2组;1组接受静脉注射免疫球蛋白,另一组接受来氟米特和静脉注射免疫球蛋白.P<0.05被认为具有统计学意义。
结果：静脉注射免疫球蛋白组3例，静脉注射免疫球蛋白+来氟米特组7例，治疗2个月后BK病毒聚合酶链反应检测结果为阴性。各组的BK病毒量显著下降，3个月后，两组之间观察到显着差异（P=0.014）。静脉免疫球蛋白组治疗后1、2、3个月肌酐平均水平分别为1.7±0.23,1.8±0.5,1.5±0.3,静脉注射免疫球蛋白+来氟米特组分别为2.1±0.75、1.76±0.37和1.4±0.18（P>.05）。
结论：尽管BK病毒载量在两组中均显著下降，3个月后接受静脉注射免疫球蛋白的患者与接受静脉注射免疫球蛋白+来氟米特联合治疗的患者之间存在显著差异.在静脉注射免疫球蛋白治疗中加入来氟米特似乎在降低BK病毒载量方面具有更好的效果。然而,需要更大样本和更长持续时间的进一步研究.
方法：本研究为随机对照临床试验。将16例BK病毒感染的肾移植患者随机分为2组;1组接受静脉注射免疫球蛋白,另一组接受来氟米特和静脉注射免疫球蛋白.P<0.05被认为具有统计学意义。
结果：静脉注射免疫球蛋白组3例，静脉注射免疫球蛋白+来氟米特组7例，治疗2个月后BK病毒聚合酶链反应检测结果为阴性。各组的BK病毒量显著下降，3个月后，两组之间观察到显着差异（P=0.014）。静脉免疫球蛋白组治疗后1、2、3个月肌酐平均水平分别为1.7±0.23,1.8±0.5,1.5±0.3,静脉注射免疫球蛋白+来氟米特组分别为2.1±0.75、1.76±0.37和1.4±0.18（P>.05）。
结论：尽管BK病毒载量在两组中均显著下降，3个月后接受静脉注射免疫球蛋白的患者与接受静脉注射免疫球蛋白+来氟米特联合治疗的患者之间存在显著差异.在静脉注射免疫球蛋白治疗中加入来氟米特似乎在降低BK病毒载量方面具有更好的效果。然而,需要更大样本和更长持续时间的进一步研究.
