移植肾功能稳定受者肾动脉阻力指数的影响因素

Factors Influencing the Kidney Artery Resistance Index in Patients with Stable Kidney Graft Function

目的 探讨移植肾功能稳定受者肾动脉阻力指数(RI)的影响因素。资料与方法 回顾性分析2016年9月—2019年9月于苏州大学附属第一医院就诊的133例移植肾功能稳定受者,根据移植肾动脉RI值分为低RI组(RI<0.7)64例和高RI组(RI≥0.7)69例。收集临床资料(年龄、性别、术后随访时间、肾病病史时长、透析方式及时间、供体年龄、供肾冷缺血时间、热缺血时间等)、实验室检查(血清肌酐并估算肾小球滤过率、总胆固醇、甘油三酯、他克莫司浓度、环孢素A浓度、24 h尿蛋白量等)结果,比较两组间的差异。构建二元Logistic回归模型分析移植肾动脉RI的影响因素。结果 两组移植肾受者年龄(t=3.419)、血清肌酐(t=2.235)、肾小球滤过率(t=2.316)、甘油三酯(t=2.675)比较,差异有统计学意义(P均<0.05)。以RI高、低作为因变量,纳入受者年龄、血清肌酐、肾小球滤过率、总胆固醇、甘油三酯作为自变量进行二元Logistic回归分析,结果显示受者年龄(P=0.002)、血清甘油三酯(P=0.008)纳入模型,年龄增长和血清甘油三酯升高是高RI的危险因素。结论 在移植肾功能稳定受者中,受者年龄及血清甘油三酯是移植肾动脉RI的显著影响因素。

Purpose To investigate the influencing factors of renal artery resistance index(RI).Materials and Methods A total of 133 kidney transplant recipients with stable graft function treated in the First Affiliated Hospital of Soochow University from September 2016 to September 2019 were analyzed retrospectively.According to the RI value of transplanted renal artery,all patients were divided into two groups:low RI(RI<0.7)group(n=64)and high RI(RI≥0.7)group(n=69).Their clinical data such as age,gender,postoperative follow-up time,history time of chronic kidney disease,dialysis method,dialysis time,donor age,cold and warm ischemia time of donor kidney,and laboratory data including serum creatinine and estimated glomerular filtration rate,total cholesterol,triglycerides,the blood concentration of tacrolimus and cyclosporine A,24-hour urine protein,were collected and further compared between the two groups.The binary Logistic regression model was constructed to analysis the influencing factors of RI.Results There was significant difference in recipient age between the two groups(t=3.419).There were significant differences in serum creatinine(t=2.235),estimated glomerular filtration rate(t=2.316),and triglyceride(t=2.675)between the two groups,respectively(all P<0.05).Age,serum creatinine,estimated glomerular filtration rate,total cholesterol,and triglycerides were taken as independent variables.Age(P=0.002)and serum triglyceride concentration(P=0.008)were the related factors of the level of RI via binary Logistic regression analysis,showing that the increased age and elevated triglycerides were the risk factors for high RI.Conclusion In kidney transplant recipients with stable kidney function,the graft artery RI is significantly closely related to the age and serum triglyceride.