肾移植术后贫血的危险因素分析

Risk Factors for Development of Posttransplantation Anemia Following Kidney Transplantation

【目的】探讨肾移植术后贫血(PTA)的发生率、风险因素。【方法】分析2004年1月至2008年6月在本院进行肾移植术的患者资料,并根据术后是否发生PTA将患者分成PTA组(44例)及对照组(132例),记录可能引起PTA的各项参数,分别用t检验和χ2检验进行单因素分析,对P<0.2的参数进行Logistic多因素分析,计算其相对危险度(RR)及95%可信区间(95%CI)。【结果】PTA(男性血红蛋白(Hb)<120g/L或红细胞压积(Hct)<0.38或成年女性Hb<110g/L或Hct<0.35)在本中心的发病率为31%。单因素及Logistic多因素回归分析表明:女性(RR=8.738;95%CI2.558～29.853;P=0.001);平均肌酐水平(RR=1.035;95%CI1.018～1.052;P<0.001)以及急性排斥(RR=19.827;95%CI2.056～191.19;P=0.01)等3项因素与PTA的发生密切相关。【结论】PTA是肾移植术后一项常见的并发症,女性、移植肾功能较差以及急性排斥的发生是PTA的危险因素。

【Objective】 To investigate the incidence and risk factors for posttransplantation anemia （PTA） following kidney transplantation.【Methods】 A retrospective cohort study reviewing the medical records of the patients who received a renal transplant at our center from January 2004 to June 2008 was performed.All possible risk factors for PTA were recorded.Outcomes among the patients with PTA were compared with those without PTA using t-test and chi-square analysis methods.Logistic regression analysis was done to rank the relative risk of potential variables and calculate the 95% CI.【Results】 Prevalence of PTA in our center was 31.0% （hemoglobin 120 g / L or Hct 0.38 for males, 110 g / L or Hct 0.35 for males）.Univariate and Logistic regression analysis revealed that the risk factors for PTA after kidney transplantation were female （RR = 8.738;95%CI 2.558 ～ 29.853;P = 0.001）,creatinine level （RR = 1.035;95%CI 1.018 ～ 1.052;P 0.001） and acute rejection （RR = 19.827;95%CI 2.056 ～ 191.19;P = 0.01）;【Conclusions】 PTA is a frequent complication after kidney transplantation.Great attention should be paid to this complication considering its negative effect on graft function.Female,impaired renal function and acute rejection are risk factors of anemia in kidney transplantation recipients.