代谢综合征对肾癌术后肾脏功能和病理改变的影响

Effect of metabolic syndrome on postoperative renal function in clear cell renal carcinoma patient

目的:探讨代谢综合征(MS)对肾癌患者术后肾脏功能及肾脏病理改变的影响。方法:回顾分析2012年12月至2017年1月期间于福建医科大学福总临床医学院肾癌根治术后病理确诊为肾透明细胞癌合并MS患者的病理资料及术后随访的临床资料。结果:两组患者术后估算的肾小球滤过率(eGFR)均较术前显著下降(P<0.001),术后1周两组间eGFR值无差异(P=0.232),随访中,两组间各时间点eGFR值差异逐渐增大存在统计学差异(P<0.05)。随访中,MS组CKD3a期及以上的患者数多于非MS组(P=0.048)。MS组癌旁肾组织脏病理可见肾小球球性硬化、肾小管萎缩及肾间质纤维化等改变。结论:MS可导致肾小球硬化及肾小管萎缩、肾间质纤维化等病变,可影响单侧根治性肾切除术后健侧肾功能的代偿,术后应密切随访患者肾功能的变化。

Objective:To investigate the postoperative renal function changes and renal pathological changes related to metabolic syndrome(MS)in patients with clear cell renal carcinoma.Methodology:We retrospectively screened clinical information for patients who underwent radical nephrectomy(RN)for clear renal cell carcinoma from December 2012 to January 2017 in Fuzhou Clinical Medical College of Fujian Medical University.Results:The postoperative eGFR of both groups was significantly lower than that of preoperative(P<0.001).There was no statistically significant in eGFR value at 1 week after operation between the two groups(P>0.05).During the follow-up,there was a statistically significant difference in eGFR value at each time point between the two groups(P<0.05).The number of patients in MS group with CKD3 a and above is more than that in non-MS group(P=0.048).Renal pathological changes in MS patients included glomerular sclerosis,tubular atrophy and renal interstitial fibrosis.Conclusion:Renal pathological changes with MS mainly include glomerular sclerosis,renal tubular atrophy and renal interstitial fibrosis MS affects the recovery of postoperative renal function in RN patients with clear cell renal carcinoma.