慢性排斥反应致移植肾失功的危险因素分析  

Analysis of risk factors for loss of renal graft caused by chronic rejection

作　　者：陆一凡 刘一霆 陈忠宝[1] 马枭雄 张龙[1] 邹寄林[1] 周江桥[1] 邱涛[1] Lu Yifan;Liu Yiting;Chen Zhongbao;Ma Xiaoxiong;Zhang Long;Zou Jilin;Zhou Jiangqiao;Qiu Tao(Organ Transplantation Department,Renmin Hospital of Wuhan University,Hubei Wuhan 430060,China)

机构地区：[1]武汉大学人民医院器官移植科,湖北武汉430060

出　　处：《实用器官移植电子杂志》2024年第4期315-319,共5页Practical Journal of Organ Transplantation(Electronic Version)

基　　金：国家自然科学基金(81870067);国家自然科学基金(82170664)。

摘　　要：目的探究肾移植术后受体移植肾丢失的主要原因,并分析可能导致受体因慢性排斥反应而发生移植肾丢失的独立危险因素。方法回顾性分析武汉大学人民医院器官移植科2015年1月至2023年1月期间所有肾移植受体的预后情况。选取14例因慢性排斥反应发生移植肾失功的受体作为病例组,28例同时期供肾无丢失的供体对应56例受体为对照组,回顾性分析两组受体和对应供体的临床资料,进行Logistic回归分析。结果本中心8年来移植肾丢失共计147例,其中移植肾失功67例,移植患者死亡80例。移植肾失功原因的前3位分别为慢性排斥反应、血管栓塞和肾病复发。移植患者死亡原因前3位分别为肺部感染、感染和心血管疾病。多因素Logistic回归分析显示病例组和对照组之间的供体年龄差异具有统计学意义(P=0.012)。结论本中心慢性排斥反应是移植肾失功最主要的原因,肺部感染是肾移植患者死亡的主要原因。供体年龄是慢性排斥反应移植肾失功的独立危险因素。Objective To investigate the main causes of kidney transplantation graft loss,and analyze independent risk factors for loss of graft by chronic rejection.Methods The prognosis of all kidney transplant recipients from January 2015 to January 2023 was retrospectively analyzed.A total number of 14 recipients with renal graft loss due to chronic rejection were selected as the case group,and 56 recipients corresponding to 28 donors without donor kidney loss were selected as the control group.Clinical data of the two groups of recipients and corresponding donors were retrospectively analyzed,and logistic regression analysis was carried out.Results In the past 8 years,147 cases experienced renal graft loss,including 67 cases of renal graft dysfunction and 80 cases of death.The top three causes of renal graft dysfunction were chronic rejection,vascular embolism and relapse of nephropathy.The top three causes of death in transplant patients were infection,cardiovascular accidents and digestive complications.Multivariate logistic regression analysis showed that there was a statistically significant difference in donor age between the case group and the control group(P=0.012).Conclusion In our center,chronic rejection was the main cause of renal graft failure.The leading causes of death in kidney transplant patients are infection and cardiovascular problems.Age of the donors is the independent risk factor for renal graft loss by chronic rejection.

关 键 词：移植肾丢失 感染 慢性排斥反应 

分 类 号：R699.2[医药卫生—泌尿科学]