摘要
目的分析肾移植受者体重指数(BMI)与预后的相关性。方法回顾性选取2003年1月至2015年12月江苏省人民医院收治的356例肾移植受者作为研究对象,根据术前BMI分为偏瘦组(BMI<18.5 kg/m^(2),n=51)、正常组(18.5 kg/m^(2)≤BMI<25.0 kg/m^(2),n=186)、超重组(25.0 kg/m^(2)≤BMI<30.0 kg/m^(2),n=86)和肥胖组(BMI≥30.0 kg/m^(2),n=33)。比较4组患者的基线资料、围手术期资料与随访结果。结果4组患者的性别构成比、年龄、肾衰竭原因、术前透析时间、透析方式、供体热缺血时间、冷缺血时间、免疫诱导及免疫抑制方案、HLA错配数等基线资料比较,差异均无统计学意义(P>0.05)。肥胖组患者的血肌酐恢复正常所需时间、移植肾功能恢复延迟、急性排斥反应的发生率分别为(10.9±3.9)d、54.5%、45.5%,均显著高于偏瘦组[(7.0±2.0)d、19.6%、11.8%]、正常组[(7.6±2.3)d、23.1%、14.0%]、超重组[(8.1±2.6)d、30.2%、19.8%],超重组的血肌酐恢复正常所需时间显著高于偏瘦组,差异均有统计学意义(P<0.05)。肥胖组的术后5年内的慢性移植肾病发生率为63.6%,明显高于偏瘦组(35.3%)和正常组(40.3%),差异有统计学意义(P<0.05)。4组术后1年内的慢性移植肾病发生率、术后1年及5年内的死亡率比较,差异均无统计学意义(P>0.05)。结论肾移植受者BMI与预后有一定相关性,肥胖者术后移植肾功能的恢复较慢,急性排斥反应与慢性移植肾病发生率较高,但并不明显增加患者的死亡风险。
Objective To analyze the correlation between body mass index(BMI)and prognosis in renal transplant recipients.Methods Three hundred and fifty-six renal transplant recipients admitted in Jiangsu Provincial People's hospital from January 2003 to December 2015 were retrospective enrolled for the research and divided into lean group(BMI<18.5 kg/m^(2),n=51),normal group(18.5 kg/m^(2)≤BMI<25.0 kg/m^(2),n=186),overweight group(25.0 kg/m^(2)≤BMI<30.0 kg/m^(2),n=86)and obesity group(BMI≥30.0 kg/m^(2),n=33)according to the preoperative BMI.The baseline data,perioperative data and follow-up result were compared among four groups.Results There were no statistically significant differences in baseline data including gender,age,cause of renal failure,preoperative dialysis time,dialysis mode,donor warm ischemia time,cold ischemia time,immune induction and immunosuppression protocol and HLA mismatch number among four groups(P>0.05).The number of days needed for serum creatinine to return to normal,the incidences of delayed recovery of graft function and acute rejection in obese group were(10.9±3.9)d,54.5%,45.5%,(7.0±2.0)d,19.6%,11.8%,(7.6±2.3)d,23.1%,14.0%,(8.1±2.6)d,30.2%,19.8%,significantly higher than those in lean group[(7.0±2.0)d,19.6%,11.8%],normal group[(7.6±2.3)d,23.1%,14.0%],overweight group[(8.1±2.6)d,30.2%,19.8%],and the number of days needed for serum creatinine to return to normal in overweight group was significantly higher than that in lean group,the differences were statistically significant(P<0.05).The incidence of chronic allograft nephropathy within 5 years after operation in obese group was 63.6%,which was significantly higher than those in lean group(35.3%)and normal group(40.3%),the difference was statistically significant(P<0.05).There were no significant differences in the incidences of chronic allograft nephropathy within 1 year after operation and the mortality within 1 year and 5 years after operation among four groups(P>0.05).Conclusion There is a certain correlation between BMI and prognosis of renal transplant recipients.The recovery of renal transplant function is slow in obese patients and their incidence of acute rejection and chronic allograft nephropathy is high,but it does not significantly increase the risk of death.
作者
张玲玲
王雪静
解修园
王子杰
ZHANG Ling-ling;WANG Xue-jing;XIE Xiu-yuan(Department of Urology,Jiangsu Provincial People's Hospital,Nanjing Jiangsu 210029,China)
出处
《临床和实验医学杂志》
2021年第21期2311-2314,共4页
Journal of Clinical and Experimental Medicine
基金
国家自然科学基金资助项目(编号:81900684)。
关键词
肾移植术
体重指数
急性排斥反应
慢性移植肾病
预后
Renal transplant
Body mass index
Acute rejection
Chronic allograft nephropathy
Prognosis
