肾移植患者肾炎复发对其远期生存时间的影响研究

Effects of recurrence of nephritis on long-term survival in renal transplant recipients

目的研究肾移植患者肾炎复发对其远期生存时间的影响。方法对80例成功完成肾移植患者进行随访观察,根据是否发生肾炎复发将其分为复发组(n=23)与对照组(n=57),比较肾移植后6个月时两组血清肌酐(SCr)、尿素氮(BUN)及24 h尿蛋白定量(24 hUPE)等肾功能指标,并随访两组5年内移植肾存活及患者生存情况。结果本研究术后中位随访时间49(26～74)个月,结果显示,复发肾炎23例(28.75%);复发组SCr、BUN及24 hUPE高于对照组(P <0.05);两组移植肾第1年存活率比较无明显差异(P> 0.05),但复发组第3、5年存活率低于对照组(P <0.05);肾移植后1年及3年,两组生存率无明显差异(P> 0.05),但复发组5年生存率低于对照组(P <0.05)。结论肾炎患者肾移植后肾炎复发率较高,且有较高风险导致移植肾肾功能丧失,并降低患者远期生存时间。

Objective To study the effects of recurrence of nephritis on long-term survival in renal transplant recipients.Methods A total of 80 patients having undergone renal transplantation successfully were followed up and divided into a recurrence group(n=23)and a control group(n=57).The renal function indicators[serum creatinine(SCr),blood urea nitrogen(BUN)and urinary protein after 24 hours(24 hUPE)1]were compared six months after the renal transplantation.The survival of transplanted kidneys and patients in the two groups were followed up for five years.Results The median follow-up time of this study was 49(26-74)months.The results showed that 23 cases(28.75%)had recurrent nephritis,and the SCr,BUN and 24 hUPE in the relapsed group were higher than those in the control group(P<0.05);there was no significant difference in the one-year survival rate between the two groups(P>0.05),but the three-year and five-year survival rates in the relapsed group were lower than those in the control group(P<0.05);there was no significant difference in the one-year and three-year survival rates between the two groups(P>0.05).The five-year survival rate in the relapse group was lower than that in the control group(P<0.05).Conclusion The recurrence rate of nephritis after renal transplantation is higher in patients with nephritis,and there is a higher risk of renal transplantation failure,with the long-term survival of patients reduced.