肾移植后贫血154例5年随访  

Anemia in patients after renal transplantation: Five-year follow-up in 154 cases

作　　者：郭君其[1] 王波[1] 谭建明[1] 俞波[2] 吴卫真[2] 杨顺良[2] 

机构地区：[1]福建医科大学福总临床学院,福建省福州市350025 [2]解放军南京军区福州总医院,福建省福州市350025

出　　处：《中国组织工程研究》2013年第44期7698-7702,共5页Chinese Journal of Tissue Engineering Research

基　　金：福建省科技创新平台建设计划资助项目(2008J1006)~~

摘　　要：背景:最近研究表明,肾移植后贫血是移植后心血管疾病的重要危险因素,并且是患者死亡的独立预测指标。目的:探讨肾移植受者移植后贫血的患病率、处理方案以及危险因素。方法:回顾性分析154例在解放军南京军区福州总医院泌尿外科随访的尸体肾移植受者病例资料。采集入选患者在肾移植住院期间以及移植后1,2,3,4,5年的血常规、血生化检查结果并进行分析。结果与结论:患者肾移植当时以及其后5年贫血的患病率分别为45.5%,10.7%,9.6%,14.8%,13.5%及19.6%。患者在5年内至少出现一次贫血,其中42%经历过贫血的再发。相关分析发现血红蛋白水平与移植肾功能相关。不同性别、年龄、免疫抑制方案以及是否使用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂与贫血的患病率不存在相关性。二元Logistic回归分析显示移植后1年血肌酐、尿素氮与贫血诊断相关,而移植后5年时仅与血肌酐相关。尽管铁剂药物使用比较普遍,但促红细胞生成素在移植肾功能不全的贫血患者中却很少应用。提示肾移植后贫血患病率较高,移植肾功能不全是其发病的主要危险因素。BACKGROUND：Recent studies have shown that anemia after renal transplantation is an important risk factor for cardiovascular disease after transplantation, as wel as the independent predictor of death. OBJECTIVE：To explore the prevalence, processing and risk factors of anemia after renal transplantation. METHODS：The data of 154 cases renal transplantation recipients who fol owed-up in the Department of Urology, Fuzhou General Hospital of Nanjing Military Command were retrospectively analyzed. The blood routine and blood biochemistry of the renal transplantation patients were col ected for analysis during hospitalization and 1, 2, 3, 4 and 5 years after transplantation. RESULTS AND CONCLUSION：The prevalence of anemia during transplantation and the subsequent 5 years after transplantation were 45.5%, 10.7%, 9.6%, 14.8%, 13.5%and 19.6%, respectively. Patients had anemia at least once in five years, and 42%of the patients experienced recurrence. Relative analysis showed that hemoglobin levels were associated with function of transplanted kidney. Different genders, ages and the using of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers or not has no correlation with the prevalence of anemia. Binary Logistic regression analysis showed that serum creatinine and blood urea nitrogen levels at 1 year after transplantation were correlated with the diagnosis of anemia, and only associated with serum creatinine level at 5 years after transplantation. Iron drug is relatively common, but erythropoietin is rarely applied in the anemia patients with transplant renal insufficiency. The prevalence of anemia after renal transplantation is high, and transplant renal insufficiency is a major risk factor for the disease.

关 键 词：器官移植 肾移植 贫血 免疫抑制剂 患病率 血红蛋白 血肌酐 尿素氮 危险因素 随访 省级基金 

分 类 号：R617[医药卫生—外科学]