肾移植受者侵袭性真菌病的诊断与治疗 研究进展

Research Progress on Diagnosis and Treatment of Invasive Fungal Disease in Kidney Transplant Recipients

摘要: 肾移植是终末期肾病的核心治疗手段，显著改善患者生存质量，但术后免疫抑制状态使受者成为侵袭性真菌病(IFD)的高危人群。IFD作为肾移植术后严重感染并发症，具有起病隐匿、病情进展迅速、病死率高的特点，其早期诊断与精准治疗对改善患者预后至关重要。宏基因组二代测序(mNGS)技术的兴起为IFD诊断带来突破性进展，逐步改变了传统诊疗模式。本文系统梳理肾移植受者IFD的发病机制、临床特征、诊断技术及治疗策略的研究进展，重点分析mNGS与传统诊断方法的应用价值，为临床优化IFD诊疗流程、提高诊疗效果提供参考。

Abstract: Kidney transplantation serves as a core therapeutic approach for end-stage renal disease, which significantly improves patients’ quality of life. However, the postoperative immunosuppressive status renders recipients a high-risk population for invasive fungal disease (IFD). As a severe infectious complication after kidney transplantation, IFD is characterized by insidious onset, rapid disease progression and high mortality. Its early diagnosis and precise treatment are crucial for improving patients’ prognosis. The emergence of metagenomic next-generation sequencing (mNGS) technology has brought breakthroughs in the diagnosis of IFD, gradually transforming the traditional diagnosis and treatment model. This paper systematically reviews the research progress in the pathogenesis, clinical characteristics, diagnostic techniques and therapeutic strategies of IFD in kidney transplant recipients, with a focus on analyzing the application value of mNGS and traditional diagnostic methods, so as to provide references for clinically optimizing the diagnosis and treatment process of IFD and improving therapeutic effects.