成年男性肾移植患者性激素水平与移植肾功能关系的临床研究  

Clinical research on the relationship between sex hormone level and renal allograft function in adult male patients after renal transplantation

作　　者：贾波[1,2] 罗志刚[1] 

机构地区：[1]南华大学附属第二医院肾移植中心 [2]武汉市东西湖区人民医院泌尿外科

出　　处：《器官移植》2013年第2期84-90,共7页Organ Transplantation

摘　　要：目的了解成年男性肾移植患者的性激素水平与移植肾功能的关系。方法选择2007年至2011年间在南华大学附属第二医院肾移植中心随访的男性肾移植患者76例作为研究对象。其中42例应用环孢素(CsA)+吗替麦考酚酯(MMF)+泼尼松免疫抑制方案的患者列为CsA组,另34例应用他克莫司(FK506)+MMF+泼尼松的患者列为FK506组。另选取同期门诊健康者或无泌尿系结石、感染、肿瘤,前列腺增生症等相关疾病的23例成年男性患者作为普通对照组,选取12例同期门诊诊断为尿毒症患者作为尿毒症对照组。检测与比较4组研究对象的平均收缩压水平、血清总胆固醇水平、血清甘油三酯水平、血清睾酮水平、血清雌二醇水平、血清睾酮/雌二醇比值、血清肌酐(Scr)水平、血清胱抑素C水平;采用直线相关分析研究CsA组和FK506组患者的肾移植术后时长、平均收缩压、血清总胆固醇、血清甘油三酯、血清雌二醇、血清睾酮水平、血清睾酮/雌二醇比值共7个变量分别与血清Scr和血清胱抑素C的关系;以睾酮/雌二醇比值和血清胱抑素C水平为两个变量,CsA组和FK506组分别绘制散点图,并行直线相关分析。结果 CsA组、FK506组患者的平均收缩压水平、血清总胆固醇水平、血清甘油三酯水平、血清睾酮水平、血清雌二醇水平、血清睾酮/雌二醇比值、血清胱抑素C水平、Scr水平与普通对照组比较差异有统计学意义(均为P<0.05)。CsA组、FK506组与尿毒症对照组比较:除血清胆固醇水平、雌二醇水平外,其余指标与尿毒症对照组比较差异均有统计学意义(均为P<0.05)。CsA组和FK506组的血清睾酮、睾酮/雌二醇比值与血清胱抑素C水平均呈正相关。结论成年男性肾移植患者的性激素水平与移植肾功能有关,尤其是血中睾酮/雌二醇的比值与血清胱抑素C呈正相关。Objective To investigate the relationship between sex hormone level and renal allograft function in adult male patients after renal transplantation. Methods Seventy-six adult male patients after renal transplantation were selected as objects fronl 2007 to 2011 in the Renal Transplantation Center of the Second Affiliated Hospital of Nanhua University. The 76 patients were divided into ciclosporin （ CsA ） group （ the immunosuppressive scheme was CsA ＋ mycophenolate mofetil （MMF） ＋ prednisone, n = 42 ） and tacrolimus （FKS06） group （ the immunosuppressive scheme was FKS06 ＋ MMF ＋ prednisone, n = 34）. At the same time, 23 adult male healthy examinees or patients that had no related diseases like urinary tract stones, infection, tumor and prostatic hyperplasia, were selected as ordinary control group. And 12 male patients with uremia were selected as uremia control group. Several indicators were detected and compared in 4 groups, including the average systolic pressure level, serum total cholesterol level, serum triglyceride level, serum testosterone （Te） level, serum estradiol （E2 ） level, Te/E2 ratio, serum creatinine（ Scr）level and serum cystatin C level. Linear correlation analysis was used to analyze the relationship between 7 variables and Scr, or/and serum eystatin C level respectively, including average systolic pressure, serum total cholesterol level, serum triglyceride level, serum E2 level, serum Te level. As Te/E2 ratio and serum eystatin C level were two variables, scatter diagrams were drawn and linear correlation analysis was used in CsA group and FK506 group. Results There was significant difference between CsA group, FK506 group and ordinary control group in the average systolic pressure, serum total cholesterol level, serum triglyceride level, serum Te level, serum E2 level, Te/E2 ratio, serum cystatin C level and Scr level （ all in P 〈 0. 05 ）. There was significant difference between CsA group, FKS06 group and uremia control group in other targets except

关 键 词：肾移植 性激素 睾酮 雌二醇 胱抑素C 

分 类 号：R617[医药卫生—外科学]