体重指数与脑心双死亡肾移植受者早期肾功能的影响关系

The influence of body mass index and the early graft function in Kidney transplant recipient from brain and cardiac death donors

目的探讨体重指数(BMI)与脑心双死亡供肾(DBCD)肾移植受者早期肾功能的关系。方法回顾性分析2011年9月至2015年8月在本院首次行肾脏移植受者80例的临床资料,受者根据中国成人肥胖标准分为三组:消瘦组(BMI<18.5kg/m^2)、正常体重组(BMI:18.5~23.9kg/m^2)、超重肥胖组(BMI>23.9kg/m^2),观察三组受者移植术后1周实验室指标(空腹血糖、血红蛋白、血清白蛋白、血尿酸、总胆固醇和甘油三酯)、移植肾功能延迟恢(DGF)复发生率、术后1周、1年血肌酐水平、术后1年人肾存活率、术后1周和1年进行Scr与BMI相关分析。结果随访1年,三组受者血肌酐水平比较差异无统计学意义(P>0.05);三组受者术后1周血红蛋白、血清白蛋白、血尿酸、血肌酐、尿素氮、甘油三酯、总胆固醇水平、DGF发生率差异均无统计学意义(P>0.05);肾移植受者术后1周、1年血肌酐与体重指数不相关;消瘦组1年人肾存活率明显降低,差异有统计学意义(P<0.05)。结论BMI不影响DBCD肾移植受者早期移植肾功能,术前偏瘦受者需适当增加体重,有助于术后人肾存活。

Objective To investigate the correlation between body mass index(BMI)and early graft function of kidney transplantation from brain and cardiac death donors(DBCD).Methods A retrospective analysis of the clinical data of kidney transplantation from DBCD in our hospital from September 2011 to August 2015 was done.According to the Adult Obesity and Overweight Standard commonly used in China,these patients were divided into three groups:emaciation group(BMI<18.5 kg/m^2),normal group(BMI 18.5-23.9 kg/m^2),overweight and obesity group(BMI>23.9 kg/m^2).The laboratory indexes[blood urea nitrogen(BUN),serum creatinine(Scr),fasting blood glucose,hemoglobin,serum albumin,uric acid,total cholesterol and triglyceride]and the incidence of delayed graft function(DGF)at one week after transplantation were compared among three groups,and graft survival rates one year after operation were compared among three groups.The correlation between Scr and BMI was analyzed.Results There was no difference in Scr level among three groups during the follow-up of 1 year(P>0.05).The BUN,Scr,fasting blood glucose,hemoglobin,serum albumin,uric acid,total cholesterol,triglyceride and DGF of the three groups showed no difference with statistical significance(P>0.05).Following-up one week and one year,the Scr level of renal transplant recipients was uncorrelated with BMI(r=0.094,P=0.412;r=0.124,P=0.286),and graft survival rates in emaciation group was lowest among the three groups(P<0.05).Conclusions BMI does not affect the recovery of early graft function in kidney transplantation DBCD,it is necessary to increase the weight of the thinner patients before operation,which is helpful to the survival of the actuarial patient and grafts.