肾移植受者术后远期发生贫血的危险因素

Risk factor of long-term anemia in kidney transplantation receptors

目的探讨同种肾移植受者术后远期发生贫血的危险因素。方法93例同种肾移植受者按照贫血与否分为贫血组和非贫血组,探讨免疫抑制剂、降压药物、移植肾功能以及其他伴随疾病对肾移植术后远期贫血的影响,同时检测两组血清促红细胞生成素的水平。结果贫血组女性受者,联合应用西罗莫司(SRL)和霉酚酸酯(MMF),应用血管紧张素转化酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)降压药物,血肌酐大于120μmol/L,慢性移植肾小球硬化,以及伴有巨细胞病毒(CMV)感染或者上消化道溃疡的肾移植受者均较非贫血组显著增多(P<0.05)。贫血组促红细胞生成素(EPO)水平显著低于非贫血组(P<0.05)。结论女性患者、联合SRL和MMF治疗、应用ACEI类或ARB类降压药,血肌酐大于120μmol/L,慢性移植肾小球硬化,以及伴有巨细胞病毒(CMV)感染或上消化道溃疡等疾病是肾移植术后远期发生贫血的危险因素。

Objective To investigate the risk factors of long - term anemia in long - term kidney transplantation receptors. Methods Ninety - three kidney transplantation receptors were divided into anemia group and non - anemia group. The factors influencing the anemia after kidney transplantation were analyzed, such as the use of immunosuppressive drugs and hypotensive drugs, transplanted kidney function,and accompanied diseases. Results The male patients,those subject to SRL and MMF therapy, ACEI or ARB hypotensive drug, and those with serum creatinine above 120 μmol/L, delayed graft function, chronic glomerular sclerosis and accompanied CMV infection or ulcer in upper gastrointestinal tract in anemia group were significantly more than those in non - anemia group （ P 〈 0. 05）. The EPO level in anemia group was significantly lower than that in non - anemia group （P 〈 0. 05）. Conclusion Combined use of SRL and MMF therapy, ACEI or ARB hypotensive drug, serum creatinine above 120μmol/L, and accompanied CMV infection or ulcer in upper gastrointestinal tract are risk factors of long - term anemia in kidney transplantation receptors.