肾移植受者并发心脑血管病的危险因素

Risk factors for cardio-cerebral vascular disease in patients after renal transplantation

目的探讨肾移植受者术后心脑血管病(cardiovascular complications,CVD)发病的危险因素。方法利用移植随访管理系统和中国肾移植科学登记系统数据资料对本院2000年1月-2010年1月间921例肾移植受者进行长期随访。依据CVD发病时间分为早期CVD组(术后1年之内发生CVD)和晚期CVD组。Kaplan-Meier乘积极限法计算CVD累积生存率,应用COX比例风险模型进行多因素分析。结果移植后新发CVD在移植后1年和移植后7年有两个高峰。早期发生CVD危险因素为移植前有CVD病史,移植前为糖尿病受者、移植术后糖尿病、高血压、高血脂、贫血、移植肾功能不全和蛋白尿是晚期CVD发病危险因素。结论针对术后不同CVD危险因素进行相应的防治可以减少肾移植受者CVD发病,从而提高移植肾的远期存活率。

Objective To study the risk factors for cardio-cerebral vascular disease（CVD） in patients after renal transplantation. Methods A total of 921 patients who underwent renal transplantation in our hospital from January 2000 to December 2010 were followed up. The patients were divided into early CVD group and late CVD according to the time of its incidence. Kaplan-Meier plot was used to calculate the accumulative survival rate of CVD patients and Cox＇ s proportional hazards model was used to analyze the risk factors for CVD. Results The incidence of CVD reached its peak 1 and 7 years, respectively, in patients after renal transplantation. History of CVD before renal transplantation is the risk factor for early CVD while histories of diabetes mellitus （DM） before renal transplantation and DM, hypertension, hyperlipidemia, anemia, renal insufficiency, proteinuria after renal transplantation were the risk factors for late CVD. Conclusion The incidence of CVD can be reduced in patients after renal transplantation and the long-term survival rate of such patients can be improved if its risk factors are appropriately controlled.