亲属活体肾移植受者术后新发代谢综合征对移植肾功能的影响

Effect of onset of metabolic syndrome on allograft function in living donor’s kidney transplantation

目的研究肾移植术后新发代谢综合征(metabolic syndrome,MS)对移植肾功能的影响。方法回顾性分析2012年8月1日至2014年8月1日郑州人民医院器官移植中心的120例亲属活体肾移植受者资料,分为MS组和非MS组,对患者术后3个月、6个月、1年、3年和5年的血肌酐值采用SPSS 16.0统计学软件进行统计学分析,两组间比较采用t检验,肾移植术后MS的危险因素采用Logis⁃tic回归分析,P值小于0.05为差异有统计学意义。结果MS组和非MS组患者术后3个月,血肌酐水平分别为(110.5±27.4)μmol/L、(109.1±34.0)μmol/L,P>0.05,差异无统计学意义。MS组和非MS组患者术后6个月,血肌酐水平分别为(119.2±32.7)μmol/L、(107.4±24.9)μmol/L,P>0.05,差异无统计学意义。MS组和非MS组患者术后1年,血肌酐水平分别为(133.6±39.6)μmol/L、(106.2±19.2)μmol/L,P<0.05,差异具有统计学意义。MS组和非MS组患者术后3年,血肌酐水平分别为(230.8±221.6)μmol/L、(110.6±23.8)μmol/L,P<0.01,差异具有统计学意义。MS组和非MS组患者术后5年,血肌酐水平分别为(266.2±103.1)μmol/L、(113.6±26.4)μmol/L,P<0.01,差异具有统计学意义。肾移植术后MS的危险因素Logistic回归分析发现,其独立危险因素有高尿酸、高三酰甘油和低的高密度脂蛋白胆固醇。结论MS已经成为肾移植受者所面临的一个重要健康问题,需要加强健康教育和健康管理。

Objective To observe the effect of onset of metabolic syndrome(MS)on allograft function after living donor’s kidney transplantation.Methods From August 1,2012 to August 1,2014,clinical data were retrospectively analyzed for 120 recipients of living related renal transplantation.Statis⁃tical analysis of serum creatine in MS and non-MS groups was conducted by SPSS 16.0 software at Month 3/6,Year 1/3/5 post-transplantation.And t-test was utilized for comparing two groups.Logistic regression was applied for risk factor analysis of MS and P<0.05 was deemed as significant.Results No significant inter-group difference existed in serum creatine at Month 3 post-transplantation.The mean value and standard deviation were(110.5±27.4)and(109.1±34.0)respectively(P>0.05).At Month 6 post-transplantation,the mean value and standard deviation were(119.2±32.7)and(107.4±24.9)respectively(P>0.05).Significant inter-group difference existed in serum creatine at Year 1 posttransplantation.The mean value and standard deviation were(133.6±39.6)and(106.2±19.2)respec⁃tively(P<0.05).At Year 3 post-transplantation,the mean value and standard deviation were(230.8±221.6)and(110.6±23.8)respectively(P<0.01).At Year 5 post-transplantation,the mean value and standard deviation were(266.2±103.1)and(113.6±26.4)respectively(P<0.01).Logistic regression revealed that the risk factors of MS were hyperuricemia,high triglyceride and low high density lipoprotein cholesterol.Conclusion MS is an important health problem in the recipients of kidney transplantation.It is imperative to develop targeted health education and intensify health management.