建立尸体肾移植术后肾功能延迟恢复风险的供者评价系统的多中心研究  

Multi-center study of establishing DGF risk assessment system for renal transplantation from deceased donor

作　　者：薛武军[1] 王长希[2] 陈江华[3] 孙煦勇[4] 武小桐 彭龙开[6] 陈知水[7] 曲青山 张小东[9] 傅耀文[10] 董震[11] 陈正[12] 丰贵文[13] 林涛[14] 门同义 于立新[16] 孙启全[17] 赵永恒[18] 周江桥[19] 曾力 赵明[21] 谭建明 叶啟发[23] 石炳毅[24] 明英姿[25] 朱同玉[26] 眭维国 黄赤兵 付迎欣[29] Xue Wujun;Wang Changxi;Chen Jianghua;Sun Xuyong;Wu Xiaotong;Peng Longkai;Chen Zhishui;Qu Qingshan;Zhang Xiaodong;Fu Yaowen;Dong Zhen;Chen Zheng;Feng Guireen;Lin Tao;Men Tongyil;Yu Lixin;Sun Qiquan;Zhao Yongheng;Zhou Jiangqiao;Zeng Li;Zhao Ming;Tan Jianming;Ye Qifa;Shi Bingyi;Ming Yingzi;Zhu Tongyu;Sui Weiguo;Huang Chibing;Fu Yingxin(The First Affiliated Hospital of Xi'an Jiaotong University,Institute of Organ Transplantation Xi'an Jiaotong University,Xi'an 710061,China;The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;The First Affiliated Hospital of Zhejiang University,Hangzhou 310003,China;People's Liberation Army 923 Hos pital,Nanning 530012,China;The Second Hospital of Shanxi People,Taiyuan 0300127,China;The Second Xiangya Hosptial of Central South University,Changsha 410011,China;Tongji Hospital of Huazhong Scientific and Technology University,Wuhan 430030,China;The Hospital of Zhengzhou People,Zhengzhou 450004,China;Chaoyang Hospital of Capital Medical University,Beijing 100027,China;The First Affiliated Baiqiuen Hospital of Jilin University,Jilin 130021,China;The First A filiated Hospital of Qingdao University,Qingdao 266071,China;The Second Affiliated Hospital of Guangzhou Medical Unirversity,Guangzhou 510150,China;The First Affiliated Hospital of Xi'an Zhengzhou University,Zhengzhou 450052,China;Huaxci Hospital of Sichuan University,Chengdu 610041,China;The First Affiliated Hospital of the first Shandong medical University,Taian 271016,China;South Hospital of south medical University,Guangzhou 510515,China;The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;The First People Hospital of Kunming City,Kunming 650034,China;People Hospital of Wuhan University,Wuhan 430060,China;Changhai Hospital of Naval Medical University,Shanghai 200433,China;Zhujiang Hospital of South Medical University,Guangzhou 510282,China;People's Liberation Army 900 Hospital,Fuzhou 350025,China;Central South Hospital of Wuhan University,Wuhan 430071,China;The Eighth Medical Cente

机构地区：[1]西安交通大学第一附属医院肾移植科西安交通大学器官移植研究所,710061 [2]中山大学附属第一医院,广州510080 [3]浙江大学医学院第一附属医院,杭州310003 [4]中国人民解放军第923医院,南宁530012 [5]山西省第二人民医院,太原0300127 [6]中南大学湘雅二院,长沙410011 [7]华中科技大学同济医学院附属同济医院,武汉430030 [8]郑州市人民医院,450004 [9]首都医科大学附属北京朝阳医院,100027 [10]吉林大学白求恩第一医院,130021 [11]青岛大学附属医院,266071 [12]广州医科大学第二附属医院,510150 [13]郑州大学第一附属医院,450052 [14]四川大学华西医院,成都610041 [15]山东第一医科大学第一附属医院,泰安271016 [16]南方医科大学南方医院,广州510515 [17]中山大学附属第三医院,广州510630 [18]昆明市第一人民医院,650034 [19]武汉大学人民医院,430060 [20]海军军医大学长海医院,上海200433 [21]南方医科大学珠江医院,广州510282 [22]联勤保障部队第900医院,福州350025 [23]武汉大学中南医院,430071 [24]解放军总医院第八医学中心,北京110108 [25]中南大学湘雅三院,长沙410013 [26]复旦大学附属中山医院,上海200433 [27]解放军联勤保障部队第924医院,桂林541002 [28]陆军军医大学第二附属医院,重庆400037 [29]天津市第一中心医院,300192

出　　处：《中华器官移植杂志》2020年第11期666-671,共6页Chinese Journal of Organ Transplantation

基　　金：中国人体器官捐献专项研究课题(CORDRF2017001)。

摘　　要：目的探讨尸体供肾肾移植术后移植肾功能延迟恢复(delayed graft function, DGF)危险因素并建立供者评分系统。方法收集自2016年11月至2018年3月全国29家移植中心实施尸体供肾移植共3 549例受者及1 875例供者临床资料,单因素分析确定DGF的供者危险因素,将其纳入多因素分析,计算回归系数(β值)并换算成危险因素的评分,建立DGF风险供者评分系统。结果单因素分析显示,供者年龄,原发疾病,高血压病史,捐献前血肌酐水平,低血压时间和心肺复苏史是肾移植术后DGF的危险因素,在不同程度上均可增加DGF发生率。通过Logistic回归模型建立了基于以上6个危险因素的总分49分的DGF风险供者评分系统,随着供者评分由0分升高至49分,肾移植术后DGF发生率由9.96%增加至92%。结论本研究确定了尸体供肾肾移植术后DGF的供者危险因素,建立了一个符合中国人口特征的DGF风险供者预测评价系统,有助于临床医师用于尸体供者的评估,指导肾移植术后DGF的防治。Objective To investigate the risk factors of delayed graft function(DGF)in organ donors after a citizen's death and establish a donor scoring system.Methods From November 2016 to March 2018,the clinical data of 1875 donors and 3549 recipients who performed renal transplantation from deceased donor in 29 transplant centers across the country were collected.Single factor analysis was used to determine the donor risk factors of DGF,and then incorporate multi-factor analysis,calculate the regression coefficient(βvalue)to establish a DGF risk donor score table.Results Univariate analysis showed that donor age,primary disease,history of hypertension,serum creatinine level before donation,hypotension and duration of CPR are risk factors for DGF after kidney transplantation,and DGF can be increased to varying degrees incidence rate.A logistic regression model was used to establish a DGF risk donor score table based on the above six risk factors with a total score of 49.As the donor score increased from 0 to 49,the incidence of DGF after renal transplantation increased from 9.96%to 92%.Conclusions The study has determined the risk factors of DGF donors after renal transplantation from decease donor,and established a scoring system for predicting DGF risk donors in line with the characteristics of the Chinese population,which is helpful for clinicians to evaluation of deceased donor and guiding treatment after renal transplantation.

关 键 词：肾移植 移植肾功能延迟恢复 供者 

分 类 号：R699.2[医药卫生—泌尿科学]