不同性别、年龄活体供肾代偿能力的比较  

Compensation of graft kidney function from living related donors in different age and gender

作　　者：孝晨[1] 傅茜[2] 刘龙山[2] 李军[2] 吴秀川[1] 彭伟[1] 王长希[2] 

机构地区：[1]武警广东省总队医院肾脏病与血液净化中心,广州510507 [2]中山大学第一附属医院器官移植中心

出　　处：《肾脏病与透析肾移植杂志》2012年第1期14-18,52,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:检测不同性别、年龄组活体供肾肾移植前后肾小球滤过率(GFR)的变化,比较各组供肾代偿能力。方法:共84例活体肾移植供者,按其年龄分为A组(>50岁)和B组(19～50岁);按供者性别分为女性组和男性组。各组术前用MDRD公式计算总体肾小球滤过率(eGFR),核素分别测定两侧GFR,按比例估算供肾术前的eGFR。计算受者移植后半年内最高eGFR,比较各组供肾eGFR移植前后变化情况。结果:总体供肾手术前后eGFR[(54.78±13.50)ml/(min·1.73m2)vs(76.68±32.23)ml/(min·1.73m2)]差异显著,代偿率32.30%(10.92%～63.89%)。A组术后eGFR明显增加[(47.16±10.43)ml/(min·1.73m2)vs(66.15±17.89)ml/(min·1.73m2)],代偿率44.35%(18.16%～63.22%);B组后eGFR代偿率30.52%(8.96%～63.01%);男性组术后eGFR代偿率33.61%(14.77%～66.96%);女性组术后eGFR代偿率25.66%(1.24%～62.45%);供肾eGFR代偿率与其术前eGFR水平及受体年龄负相关。结论:移植后各组活体供肾eGFR均明显代偿性升高,但个体差异较大。虽然A组eGFR水平在肾移植前后均低于B组,但其总体代偿能力良好。女性活体供肾与男性供体肾移植前后表现相近。术前评估活体供肾代偿能力要考虑其基础eGFR及受者需求。Objective：This study aimed to compare glomerular filtration rate （GFR） changes in the elderly and non-elderly, male and female living kidney donors before and after transplantation, and to further evaluate the compensation of GFR in each group. Methodology ： Eighty four living kidney donors were divided into the male group （ n = 54 ） and female group （n =30） ,or group A （age over 50,n =25） and group B （age 19 -50,n =59）. The total GFR was calculated with the MDRD formula, Meanwhile, bilateral GFR was determined by 99m TC-DTPA radionuclide assay, and then the preoperative estimated GFR （ eGFR ） of donor kidneys was calculated. Within half year following after operation, the maximum eGFR of graft kidneys was calculated and compared each group after operation. Results：The general eGFR of donor kidneys preoperatively was （ 54. 8 ± 13.5 ） ml/（ min · 1.73m^2 ）, while （ 76. 7 ± 32. 27 ） ml/（ min ·1.73m^2 ） postoperatively. The compensation rate of eGFR was 32. 30% （10. 92% -63.89% ）. In group A, the compensation rate of eGFR was 44. 35% （ 18.16% - 63.22% ）, while 30. 52% （ 8. 96% - 63.01% ） in group B. The compensation rate of eGFR was 33.61% （ 14. 77% - 66. 96% ） in male group while 25. 66% （ 1.24% - 62.45% ） in female group. The compensation rate of eGFR was negatively correlated with preoperative eGFR and the age of recipients. Although the pre- and post-operative eGFR of living donor kidneys in the elderly group was both lower than non-elderly group, the eGFR in the elderly group and female group was well-compensated. Conclusion：After transplantation, the eGFR compensation rate of living donor kidneys was significantly elevated, but it was significant individuals. The pre-and post-operative parameters between female and male graft were similar, and thus preoperative evaluation on the compensation of living donor kidneys should carefully consider the basic eGFR and the needs of recipients.

关 键 词：活体肾移植 边缘供肾 移植肾功能 肾小球滤过率 代偿率 

分 类 号：R699.2[医药卫生—泌尿科学]