肾移植受者术前合并代谢综合征对早期移植肾功能的影响  

Effect of preoperative metabolic syndrome on early function of renal allografts in kidney transplant recipients

作　　者：唐永斌 田子健 张志鹏[1] 王劲夫[1] 刘明[1,2] 张亚群 Tang Yongbin;Tian Zijian;Zhang Zhipeng;Wang Jinfu;Liu Ming;Zhang Yaqun(Department of Urology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院泌尿外科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]中国医学科学院,北京协和医学院研究生院 [3]天津医科大学第二医院泌尿外科,天津市泌尿外科研究所

出　　处：《器官移植》2024年第4期607-613,共7页Organ Transplantation

基　　金：中央高水平医院临床科研业务费(BJ-2022-174)。

摘　　要：目的探讨同种异体肾移植受者术前合并代谢综合征对早期移植肾功能的影响。方法回顾性分析117例肾移植受者的临床资料,根据移植肾功能分为移植物功能延迟恢复(DGF)组(29例)和非DGF组(88例),应用单因素和多因素回归分析同种异体肾移植受者发生DGF的相关危险因素,分析肾移植受者术前合并代谢综合征对早移植肾功能的影响。结果117例肾移植受者,47例术前合并代谢综合征,29例术后发生DGF,DGF组中83%术前合并代谢综合征,高于非DGF组中的74%(P<0.05)。单因素分析结果显示,DGF组供者体质量指数(BMI)、终末血清肌酐(Scr),受者术前BMI、血糖、甘油三酯水平、术前合并代谢综合征比例均高于非DGF组(均为P<0.05)。多因素logistic回归分析结果显示,供者Scr水平高、受者术前血红蛋白水平高、受者术前合并代谢综合征是肾移植术后发生DGF的独立危险因素(均为P<0.05)。结论受者术前合并代谢综合征是同种异体肾移植发生DGF的独立危险因素,应采取相关策略以减少DGF和其他与代谢相关的并发症的发生率。Objective To evaluate the effect of preoperative metabolic syndrome on early function of renal allografts in allogeneic kidney transplant recipients.Methods Clinical data of 117 kidney transplant recipients were retrospectively analyzed.According to the renal allograft function,they were divided into the delayed graft function(DGF)group(n=29)and non-DGF group(n=88).Relevant risk factors of DGF in recipients undergoing allogeneic kidney transplantation were assessed by univariate and multivariate regression analyses.The effect of preoperative metabolic syndrome on early function of renal allografts was analyzed.Results Among 117 kidney transplant recipients,47 cases were complicated with preoperative metabolic syndrome,and 29 cases developed postoperative DGF.In the DGF group,83%of the recipients were complicated with preoperative metabolic syndrome,higher than 74%in the non-DGF group(P<0.05).Univariate analysis showed that the body mass index(BMI)and terminal serum creatinine(Scr)level of the donors,and BMI,blood glucose level,triglyceride level and the proportion of preoperative metabolic syndrome of the recipients in the DGF group were higher than those in the non-DGF group(all P<0.05).Multivariate logistic regression analysis revealed that high Scr levels of the donors,high hemoglobin levels of the recipients and preoperative metabolic syndrome of the recipients were the independent risk factors for DGF after kidney transplantation(all P<0.05).Conclusions Preoperative metabolic syndrome is an independent risk factor for DGF in allogeneic kidney transplant recipients.Corresponding measures should be taken to lower the incidence of DGF and other metabolic complications.

关 键 词：肾移植 代谢综合征 肥胖 血糖 血脂 移植物功能延迟恢复 血清肌酐 估算肾小球滤过率 

分 类 号：R617[医药卫生—外科学] R589[医药卫生—临床医学]