网织红细胞相关参数在监测肾移植术后早期恢复中的临床意义  

Clinical Significance of Reticulocyte Related Parameters in Monitoring Early Recovery after Renal Transplantation

作　　者：乾珍 龚雨薇 王奕乐 周梦玲 杨开 陈捷 文俊峰 卫向红[1] QIAN Zhen;GONG Yu-wei;WANG Yi-le;ZHOU Meng-ling;YANG Kai;CHEN Jie;WEN Jun-feng;WEI Xiang-hong(School of Medicine,Wuhan University of Science and Technology,Wuhan,Hubei 430022,China;The First People'sHospital of Xiangyang,Xiangyang,Hubei 441000,China)

机构地区：[1]武汉科技大学医学院,湖北武汉430022 [2]襄阳市第一人民医院,湖北襄阳441000

出　　处：《湖北医药学院学报》2023年第4期392-395,400,共5页Journal of Hubei University of Medicine

摘　　要：目的:观察进行肾移植手术后的患者网织红细胞相关参数的变化规律,探讨网织红细胞相关参数在评价肾功能早期恢复过程中的临床意义。方法:采用回顾性研究方法,选取45例肾衰竭患者(研究组),所有患者均接受肾移植手术治疗。检测其术后第1、7、14、28、56天红细胞(RBC)、血红蛋白含量(HGB)、红细胞分布宽度(RDW)和网织红细胞相关参数,包括网织红细胞百分比(RET%)、网织红细胞绝对值(RET#)、未成熟网织红细胞百分比(IRF%)、中荧光强度网织红细胞(MFR),并检测该患者肌酐(Cr)、尿素氮(BUN)、胱抑素C(CysC)等肾功能指标,与该患者术前各项指标进行分析比较,并与50例健康体检者(对照组)作比较,进行分析。结果:研究组术前各项指标与对照组相比,差异有统计学意义(P<0.05)。术后第1天,RET%、RET#、IRF%指标相比术前,差异具有统计学意义(P<0.05)。研究组RET%和RET#术后第7天最低,第14天有所增高,第28天与术前相比明显升高(P<0.05)。而IRF%在术后第3天最低,第7天增高,第14天与术前相比明显升高(P<0.05),MFR与IRF%变化一致。研究组Cr、BUN、CysC在术后呈下降趋势,在术后第14天与RET%呈显著负相关性(r=-0.589,P=0.001;r=-0.623,P=0.035;r=-0.424,P=0.014);在术后第28天与RET#呈显著负相关性(r=-0.611,P=0.020;r=-0.459,P=0.021;r=-0.496,P=0.004)。研究组RBC、HGB术后56天与术前相比显著升高,但低于对照组(P<0.05),RDW术后有所降低,短期内变化不明显,与术前相比差异无统计学意义(P>0.05)。结论:网织红细胞相关参数在评价肾移植术后,肾功能早期恢复方面有一定的临床意义,值得推广运用。Objective To observe the changes of reticulocyte-related parameters in patients who underwent renal transplantation and to explore the clinical significance of reticulocyte-related parameters in the evaluation of early recovery of renal function.Methods A retrospective study was conducted in 45 patients with renal failure(study group),all of whom were treated with renal transplantation.Their red blood cells(RBC),haemoglobin content(HGB),red blood cell distribution width(RDW)and reticulocyte-related parameters,including percentage of reticulocytes(RET%),absolute reticulocyte value(RET#),percentage of immature reticulocytes(IRF%),and medium fluorescence intensity reticulocytes(MFR)were measured on postoperative days 1,7,14,28 and 56,and patient's renal function indicators such as creatinine(Cr),urea nitrogen(BUN)and cystatin C(CysC)were measured and analysed and compared with the patient's preoperative indicators,and compared with 50 healthy physical examiners(control group).Results There was a statistically significant difference between the preoperative indexes of the study group and the control group(P<0.05).At 1 day postoperatively,the differences in RET%,RET#and IRF%indicators were statistically significant(P<0.05)compared to the preoperative period.In the study group,RET%and RET#were lowest on postoperative day 7,increased on postoperative day 14 and were significantly higher on postoperative day 28 compared to preoperative(P<0.05).In contrast,IRF%was lowest on postoperative day 3,increased on day 7 and significantly higher on day 14 compared to preoperative(P<0.05),and MFR was consistent with the change in IRF%.Cr,BUN and CysC in the study group tended to decrease postoperatively and showed a significant negative correlation with RET%at postoperative day 14(r=-0.589,P=0.001;r=-0.623,P=0035;r=-0.424,P=0.014);significant negative correlation with RET#at postoperative day 28(r=-0.611,P=0020;r=-0.459,P=0.021;r=-0.496,P=0.004).RBC and HGB were significantly higher than those in the study group at 56 days postoper

关 键 词：肾移植 网织红细胞 肾衰竭 

分 类 号：R699.2[医药卫生—泌尿科学]