亲属活体供肾肾小球滤过率与受者体重比值对移植肾功能预测的研究  

Predictive value of donor＇s glomerular filtration rate to recipient＇s weight ratio in early clinical outcome in living-related donor transplantation

作　　者：张大伟[1] 李响[2] 许亮[2] 袁清[2] 韦星[2] 李树欣[2] 蔡明[2] 

机构地区：[1]解放军总医院,北京100193 [2]解放军第309医院

出　　处：《中华器官移植杂志》2017年第3期160-164,共5页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金项目（81470043）

摘　　要：目的 探讨亲属活体供肾肾小球滤过率与受者体重比值（Dg/Rw）对移植肾术后早期肾功能的的预测作用.方法 回顾性分析2014年1月至2015年7月间108例亲属活体肾移植的供、受者资料,排除：非首次移植或联合移植者;术后发生肾功能恢复延迟（DGF）者;术后1年随访期内发生超急性、加速性、急性排斥反应者;术后检查提示肾动脉狭窄和移植肾肾积水者,最终纳入90例.根据Dg/Rw将90例受者分为G1组（Dg/Rw≤0.81,25例）、G2组（0.82＜Dg/Rw＜ 1.11,36例）、G3组（Dg/Rw≥1.12,29例）.观察三组受者术后3d、7d、1个月、1年的血肌酐水平与Dg/Rw的关系.结果 受者术后3d、7d、1个月及1年血肌酐均与Dg/Rw呈线性关系（P＜0.05）.术后1年内,G1、G2组血肌酐均高于G3组（P＜0.05）,且G1、G2组早期血肌酐下降趋势也较G3组慢（P＜0.05）;但G1、G2组之间不同时间点血肌酐值的差异无统计学意义.结论 Dg/Rw较高的受者术后早期肌酐水平下降较快,且维持在较低水平.Dg/Rw对肾移植后早期受者肾功能有一定的预测作用.Objective To investigate whether the donor＇s glomerular filtration rate （GFR） to recipient＇s weight ratio （Dg/Rw） is a useful tool to predict early clinical outcome in living-related do-nor transplantation.Methods A total number of 108 living donor transplant recipients in the Chinese Military 309th Hospital from Jan.2014 to July 2015 were enrolled in this study.The patients who had multi-organ transplantation or developed grafts rejection,delayed graft function,hydronephrosis or renal vascular stenosis were excluded.The 90 qualified recipients were divided into G1 group （Dg/Rw ≤0.81）,G2 group （Dg/Rw 0.81～1.11）,and G3 group （Dg/Rw≥1.12）.We respectively analyzed the relationship between recipient＇s serum creatinine Scr and Dg/Rw at 3-,7-,30-day and 1 year after transplantation.Results Scr at 3-,7-,30-day and 1 year after transplantation had linear correlation with Dg/Rw.As compared with G1 and G2 groups,Scr level was significantly reduced in G3 group at different time points （P〈0.05）.Conclusion Dg/Rw has a negative relationship with Scr level after renal transplantation.Pre-transplant Dg/Rw is a potential index to predict the early clinical outcome in living-related donor transplantation.

关 键 词：肾移植 肾小球滤过率 肾功能 

分 类 号：R699.2[医药卫生—泌尿科学]