留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

体重指数对肾移植近期预后的影响:附单中心1041例报告

罗用文 钱叶勇 范宇 王振 李钢 柏宏伟 常京元

罗用文, 钱叶勇, 范宇, 等. 体重指数对肾移植近期预后的影响:附单中心1041例报告[J]. 器官移植, 2015, 6(6): 401-404, 433. doi: 10.3969/j.issn.1674-7445.2015.06.011
引用本文: 罗用文, 钱叶勇, 范宇, 等. 体重指数对肾移植近期预后的影响:附单中心1041例报告[J]. 器官移植, 2015, 6(6): 401-404, 433. doi: 10.3969/j.issn.1674-7445.2015.06.011
Luo Yongwen, Qian Yeyong, Fan Yu, et al. Effect of body mass index on short-term prognosis of renal transplantation: a report of 1 041 cases in a single center[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 401-404, 433. doi: 10.3969/j.issn.1674-7445.2015.06.011
Citation: Luo Yongwen, Qian Yeyong, Fan Yu, et al. Effect of body mass index on short-term prognosis of renal transplantation: a report of 1 041 cases in a single center[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 401-404, 433. doi: 10.3969/j.issn.1674-7445.2015.06.011

体重指数对肾移植近期预后的影响:附单中心1041例报告

doi: 10.3969/j.issn.1674-7445.2015.06.011
基金项目: 

首都临床特色应用研究 Z131107002213139

详细信息
    通讯作者:

    钱叶勇, Email:qianyy@medmail.com.cn

  • 中图分类号: R617

Effect of body mass index on short-term prognosis of renal transplantation: a report of 1 041 cases in a single center

More Information
  • 摘要:   目的  探讨体重指数(BMI)对肾移植术后患者近期预后的影响。  方法  回顾性分析2009年3月至2013年3月在解放军第309医院器官移植研究所首次行肾移植手术的1 041例成年患者的临床资料。根据中国常用成人肥胖与超重标准将纳入的患者分为4组:BMI < 18.5 kg/m2组(消瘦组)112例, BMI 18.5~23.9 kg/m2组(正常组)606例, BMI 24.0~27.9 kg/m2组(超重组)250例, BMI≥28.0 kg/m2组(肥胖组)73例。观察与比较4组患者术后1年的移植物功能延迟恢复(DGF)、急性排斥反应(AR)发生率, 以及计算1年人、肾存活率。采用单因素和多因素Logistic回归法分析BMI与DGF发生的关系, 以探讨不同BMI值对DGF的影响。  结果  随访1年, 肥胖组DGF的发生率明显高于正常组和消瘦组(均为P < 0.05), 但术后AR的发生率及术后1年人或肾存活率比较差异无统计学意义(均为P>0.05)。单因素分析显示肥胖增加肾移植术后发生DGF的风险(OR为1.33, P < 0.05)。多因素分析显示超重与肥胖均为肾移植术后发生DGF的独立危险因素(OR分别为1.56、1.37, 均为P < 0.05)。  结论  超重与肥胖增加术后DGF风险, 但不增加术后AR发生率, 亦不影响术后近期人、肾存活率。

     

  • 表  1  不同BMI组受者肾移植术后1年术后并发症发生率及存活率的比较

    Table  1.   Comparison of survival rate and incidence rate of complications of recipients among different BMI groups at 1 year after renal transplantation [n(%)]

    组别 n DGF AR 1年肾
    存活
    1年人
    存活
    消瘦组 112 24(21) 21(19) 111(100) 112(100)
    正常组 606 142(23) 104(17) 596(98) 602(99)
    超重组 250 74(30) 53(21) 244(98) 247(99)
    肥胖组 73 26(36) 15(21) 72(99) 72(99)
    P 0.037 0.546 0.786 0.839
    下载: 导出CSV
  • [1] 中华人民共和国卫生部疾病控制司.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社, 2006.

    Disease Control Department of Ministry of Health of the People's Republic of China. Prevention and control guidelines of Chinese adult overweight and obesity[J]. Beijing: People's Medical Publishing House, 2006.
    [2] World Health Organization. The atlas of heart disease and stroke[EB/OL]. (2015-03-04). http://www.who.int/cardiovascular_diseases/resources/atlas/en/.
    [3] Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013:a systematic analysis forthe Global Burden of Disease Study 2013[J]. Lancet, 2014, 384(9945):766-781. doi: 10.1016/S0140-6736(14)60460-8
    [4] 武阳丰, 马冠生, 胡永华, 等.中国居民的超重和肥胖流行现状[J].中华预防医学杂志, 2005, 39(5):316-320. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHYF200505005.htm

    Wu YF, Ma GS, Hu YH, et al. The current prevalence status of body overweight and obesity in China: data from the China national nutrition and health survey[J]. Chin J Prev Med, 2005, 39(5):316-320. http://www.cnki.com.cn/Article/CJFDTOTAL-ZHYF200505005.htm
    [5] Orlic L, Mikolasevic I, Jakopcic I, et al. Body mass index: short-and long-term impact on kidney transplantation[J]. Int J Clin Pract, 2015, 69(11):1357-1365. doi: 10.1111/ijcp.12715
    [6] 董丽明, 江艳, 热衣汉·谢力甫, 等.体重指数与早期移植肾功能的关系[J].器官移植, 2015, (4):254-257. http://www.organtranspl.com/browse/detail/qkid/73/id/65.html

    Dong LM, Jiang Y, Xielipu RYH, et al. Correlation between body mass index and early graft function[J]. Organ Transplant, 2015, (4):254-257. http://www.organtranspl.com/browse/detail/qkid/73/id/65.html
    [7] Karabicak I, Aytug S, Lewis S, et al. Long-term kidney transplant outcome in obese patients in a predominantly African American population[J]. Clin Transplant, 2011, 25(3):E264-E270. doi: 10.1111/ctr.2011.25.issue-3
    [8] Furriel F, Parada B, Campos L, et al. Pretransplantation overweight and obesity: does it really affect kidney transplantation outcomes?[J]. Transplant Proc, 2011, 43(1):95-99. doi: 10.1016/j.transproceed.2010.12.027
    [9] Moreira TR, Bassani T, de Souza G, et al. Obesity in kidney transplant recipients: association with decline in glomerular filtration rate[J]. Ren Fail, 2013, 35(9):1199-1203. doi: 10.3109/0886022X.2013.819735
    [10] Curran SP, Famure O, Li Y, et al. Increased recipient body mass index is associated with acute rejection and other adverse outcomes after kidney transplantation[J]. Transplantation, 2014, 97(1):64-70. doi: 10.1097/TP.0b013e3182a688a4
    [11] Cannon RM, Jones CM, Hughes MG, et al. The impact of recipient obesity on outcomes after renal transplantation[J]. Ann Surg, 2013, 257(5):978-984. doi: 10.1097/SLA.0b013e318275a6cb
    [12] Molnar MZ, Kovesdy CP, Mucsi I, et al. Higher recipient body mass index is associated with post-transplant delayed kidney graft function[J]. Kidney Int, 2011, 80(2):218-224. doi: 10.1038/ki.2011.114
    [13] de Heredia FP, Gómez-Martínez S, Marcos A. Obesity, inflammation and the immune system[J]. Proc Nutr Soc, 2012, 71(2):332-338. doi: 10.1017/S0029665112000092
    [14] Nicoletto BB, Fonseca NK, Manfro RC, et al. Effects of obesity on kidney transplantation outcomes: a systematic review and meta-analysis[J]. Transplantation, 2014, 98(2):167-176. doi: 10.1097/TP.0000000000000028
    [15] Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects), Lu Y, Hajifathalian K, et al. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants[J]. Lancet, 2014, 383(9921):970-983. doi: 10.1016/S0140-6736(13)61836-X
    [16] 林衔亮, 周浩, 吴琳, 等.肾移植受者死亡原因分析[J/CD].中华临床医师杂志:电子版, 2012, 6(11):2924-2928.

    Lin XL, Zhou H, Wu L, et al. Analysis of the death causes of renal transplantation recipients[J/CD]. Chin J Clin:Electr Edit, 2012, 6(11):2924-2928.
    [17] 敖建华, 卢锦山, 肖序仁, 等.肾移植术后存活10年以上受者的临床资料分析[J].中华器官移植杂志, 2010, 31(5):273-275. http://www.cqvip.com/QK/95674X/201005/34015613.html

    Ao JH, Lu JS, Xiao XR, et al. Retrospective clinical analysis on recipients of more than 10 years after renal transplantation[J]. Chin J Organ Transplant, 2010, 31(5):273-275. http://www.cqvip.com/QK/95674X/201005/34015613.html
    [18] Hoogeveen EK, Aalten J, Rothman KJ, et al. Effect of obesity on the outcome of kidney transplantation:a 20-year follow-up[J]. Transplantation, 2011, 91(8):869-874. doi: 10.1097/TP.0b013e3182100f3a
  • 加载中
表(1)
计量
  • 文章访问数:  179
  • HTML全文浏览量:  94
  • PDF下载量:  10
  • 被引次数: 0
出版历程
  • 收稿日期:  2015-08-20
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2015-11-15

目录

    /

    返回文章
    返回