老年人肾移植49例临床分析

Clinical analysis of renal transplantation in the elderly patients

目的探讨老年患者施行肾移植的治疗经验。方法对49例65岁以上的肾移植患者进行回顾性分析,并与同期87例＜50岁的肾移植患者作比较。结果老年组肾移植1年人存活率(85．7%),与非老年组(93．1%)差异有统计学意义；1年肾存活率(89．8%)与非老年组(90．8%)差异无统计学意义；1年内急性排斥反应的发生率(10．2%)低于非老年组(28．7%,P＜0．05)；老年组心、脑血管病的发生率(51．1%)高于非老年组(19．5%,P＜0．05)；免疫抑制剂环孢素的剂量3个月内、3～6个月及6～12个月分别为(3．6±1．1)、(3．1±0．9)mg·kg^(-1)·d^(-1)及(2．9±0．7) mg·kg^(-1)·d^(-1),均小于非老年组的(5．4±1．4)、(4．6±1．3)mg·kg^(-1)·d^(-1)及(4．1±1．0)mg·kg^(-1)·d^(-1),差异有统计学意义(P＜0．05)。结论针对老年患者的特点,积极治疗原发病,选择适当的时机,老年患者的肾移植同样可以取得满意的治疗效果。

Objective To investigate the clinical effect of renal transplantation in elderly patients. Methods Retrospective analysis was held on 49 elderly patients aged over 65 years who underwent renal transplantation, and compared with 87 patients under the age of 50 years who underwent the renal transplantation during the same time. Results The survival rate at one year was 85.7% in elderly patients, and 93.1% in the non-elderly patients（P〈0.05）. The graft survival rate at one year was 89.8% in elderly patients, and 90.8% in the non-elderly patients, but no significant difference was found between the two groups. The rate of acute rejection response was 10.2% in elderly patients, significantly lower than that in non-elderly patients （28.7%）. The rate of complication of eardio-eerebrovaseular diseases in elderly patients （51.1%） were higher than those in non-elderly patients （19.5%, P〈0.05）. The dosages of immunosuppressive agent eyelosporine in 3 months, 3-6 months and 6-12 months were（ 3.6±1.1）,（3.1±0.9）mg·kg^-1·d^-1 and （2.9±0.7）mg·kg^-1·d^-1 in elderly group,significantly lower than those[（5.4±1.4）, （4.6±1.3）mg·kg^-1·d^-1 and（4. 1±1.0） mg·kg^-1·d^-1 in non-elderly group（P〈0.05）. Conclusions Renal transplantation in elderly patients is effective and reliable.