肾移植术后受者体质量指数对其死亡的影响分析

Analysis of Body Mass Index in Recipients after Kidney Transplantation and Its Impact on the Death

【目的】探究肾移植术后受者体质量指数对其死亡的影响。【方法】回顾分析本院2001～2010年死亡的207例肾移植受者资料。根据受者术后随访期间的身体质量指数（BM I ）将其分为偏瘦组（BM I＜18．5 kg/m2，n ＝55）、正常组（18．5 kg/m2≤BMI＜24k g/m2，n＝100）和超重组（BMI≥24 kg/m2，n＝52），对三组受者死亡原因、受者存活率和移植肾存活率进行比较分析。【结果】所有受者的前三位死亡原因依次为感染（31．9％）、心血管疾病（21．3％）和肝功能衰竭（15．9％）；超重组中移植肾失功能死亡和因心血管疾病死亡的比率均明显高于偏瘦组和正常组（P＜0．05）；正常组肾移植术后受者存活率明显高于偏瘦组和超重组（P ＜0．05）；正常组术后3年、5年受者存活率明显高于偏瘦组和超重组（P＜0．05），但1年、10年受者存活率三组比较无统计学差异（P＞0．05）；正常组肾移植术后移植肾存活率明显高于偏瘦组和超重组（ P＜0．05）。【结论】肾移植术后受者BM I≥24 kg/m2是增加心血管疾病死亡和降低受者及移植肾存活率的一个风险因素。

[Objective] To explore the impact of body mass index （BMI） of recipients after kidney transplanta-tion on the death .[Methods]Clinical data of 207 recipients after kidney transplant died from 2001 to 2010 in our hospital were analyzed retrospectively .According to BMI of recipients during the postoperative follow up ,the re-cipients were divided into low weight group（BMI 18 .5kg/m2 ,n =55） ,normal weight group（18 .5kg/m2 ≤BMI 24kg/m2 ,n =100） and overweight group（BMI≥24kg/m2 ,n =52） .Death causes and survival rate of recipients and transplanted kidney among 3 groups were analyzed and compared .[Results] The top 3 death causes of all re-cipients were infection（31 .9% ） ,cardiovascular disease（21 .3% ） and hepatic failure（15 .94% ） .The proportion of patients who died from the loss of transplanted kidney function or cardiovascular disease in overweight group was higher than that in low weight group and normal control group （ P 〈0 .05） .The survival rate of recipients after kidney transplantation in normal control group was obviously higher than that in low weight group and overweight group（ P 〈0 .05） .The 3-year and 5-year survival rate in normal control group was obviously higher than that in low weight group and overweight group（ P 〈0 .05） ,but there was no significant difference in 1-year and 10-year survival rate among 3 groups（ P 〉0 .05） .The survival rate of transplanted kidney after renal transplantation in normal control group was obviously higher than that in low weight group and overweight group （ P 〈 0 .05） .[Conclusion] The recipients with BMI ≥ 24kg/m2 after kidney transplantation is a risk factor of increasing the death caused by cardiovascular disease and decreasing the survival rate of recipients and transplanted kidney .