体重指数对肾移植近期预后的影响:附单中心1041例报告  

Effect of body mass index on short-term prognosis of renal transplantation: a report of 1 041 cases in a single center

作　　者：罗用文 钱叶勇[2] 范宇[2] 王振[2] 李钢[2] 柏宏伟[2] 常京元[2] 

机构地区：[1]解放军医学院,北京100091 [2]解放军第309医院全军器官移植研究所

出　　处：《器官移植》2015年第6期401-404,433,共5页Organ Transplantation

基　　金：首都临床特色应用研究(Z131107002213139)

摘　　要：目的：探讨体重指数（BMI）对肾移植术后患者近期预后的影响。方法回顾性分析2009年3月至2013年3月在解放军第309医院器官移植研究所首次行肾移植手术的1041例成年患者的临床资料。根据中国常用成人肥胖与超重标准将纳入的患者分为4组：BMI ＆lt;18.5 kg／m2组（消瘦组）112例，BMI 18.5～23.9 kg／m2组（正常组）606例，BMI 24.0～27.9 kg／m2组（超重组）250例， BMI≥28.0 kg／m2组（肥胖组）73例。观察与比较4组患者术后1年的移植物功能延迟恢复（DGF）、急性排斥反应（AR）发生率，以及计算1年人、肾存活率。采用单因素和多因素 Logistic 回归法分析BMI 与 DGF 发生的关系，以探讨不同 BMI 值对 DGF 的影响。结果随访1年，肥胖组 DGF 的发生率明显高于正常组和消瘦组（均为 P＆lt;0.05），但术后 AR 的发生率及术后1年人或肾存活率比较差异无统计学意义（均为 P ＞0.05）。单因素分析显示肥胖增加肾移植术后发生 DGF 的风险（OR 为1.33， P ＆lt;0.05）。多因素分析显示超重与肥胖均为肾移植术后发生 DGF 的独立危险因素（OR 分别为1.56、1.37，均为 P ＆lt;0.05）。结论超重与肥胖增加术后 DGF 风险，但不增加术后 AR 发生率，亦不影响术后近期人、肾存活率。Objective To investigate the effect of body mass index （BMI）on short-term prognosis of patients after renal transplantation.Methods Clinical data of 1 041 adult patients undergoing the first renal transplantation in the Institute of Organ Transplantation of the 309 th Hospital of People＇s Liberation Army from March 2009 to March 201 3 were retrospectively studied.According to the Adult Obesity and Overweight Standard commonly used in China,these patients were divided into 4 groups：112 patients in BMI 〈1 8.5 kg/m2 group （emaciation group）,606 patients in BMI 1 8.5-23.9 kg/m2 group （normal group）,250 patients in BMI 24.0-27.9 kg/m2 group （overweight group）and 73 patients in BMI≥28.0 kg/m2 group （obesity group）.The incidence of delayed graft function （DGF）and acute rejection （AR）of the 4 groups one year after renal transplantation were observed and compared.One-year patient and graft survival rates were calculated.The relationship between BMI and DGF was studied by univariate and multivariate Logistic regression analysis to investigate the effect of different BMI on DGF.Results After the follow-up for one year,the incidence of DGF in the obesity group was significantly higher than that in the emaciation group and the normal group（both in P 〈0.05）.The difference in the incidence of acute rejection one year after renal transplantation as well as one-year patient or graft survival rate had no statistical significance （all in P ＆gt;0.05）.Univariate analysis showed that＆amp;nbsp;obesity increased the risk of DGF after renal transplantation （OR was 1 .33,P 〈0.05）.Multivariate analysis showed that both overweight and obesity were independent risk factors of DGF after renal transplantation （OR was respectively 1 .56 and 1 .37,both in P 〈0.05）.Conclusions Overweight and obesity increases the risk of DGF after renal transplantation,but do not increase the incidence of AR after renal transplantation and do no influence short-term patient and graft survival rates aft

关 键 词：体重指数 肾移植 肾功能延迟恢复 急性排斥反应 

分 类 号：R617[医药卫生—外科学]