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肾移植术后受体脑卒中危险因素分析

杜鹏 张蓬杰 段斌 陈瑞 丁通

杜鹏, 张蓬杰, 段斌, 等. 肾移植术后受体脑卒中危险因素分析[J]. 器官移植, 2018, 9(2): 142-146. doi: 10.3969/j.issn.1674-7445.2018.02.009
引用本文: 杜鹏, 张蓬杰, 段斌, 等. 肾移植术后受体脑卒中危险因素分析[J]. 器官移植, 2018, 9(2): 142-146. doi: 10.3969/j.issn.1674-7445.2018.02.009
Du Peng, Zhang Pengjie, Duan Bin, et al. Analysis of risk factors for cerebral apoplexy in the recipients after renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(2): 142-146. doi: 10.3969/j.issn.1674-7445.2018.02.009
Citation: Du Peng, Zhang Pengjie, Duan Bin, et al. Analysis of risk factors for cerebral apoplexy in the recipients after renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(2): 142-146. doi: 10.3969/j.issn.1674-7445.2018.02.009

肾移植术后受体脑卒中危险因素分析

doi: 10.3969/j.issn.1674-7445.2018.02.009
基金项目: 

陕西省科技计划项目 2012SF2-12

详细信息
    通讯作者:

    杜鹏,男,1973年生,硕士,副主任医师,研究方向为肾移植和血液透析,Email: seasonn@163.com

  • 中图分类号: R617, R743

Analysis of risk factors for cerebral apoplexy in the recipients after renal transplantation

More Information
  • 摘要:   目的  分析肾移植受体发生脑卒中的危险因素。  方法  回顾性分析376例规律随访的肾移植受体的临床资料,按照是否发生脑卒中分为脑卒中组(39例)和非脑卒中组(337例)。采用单因素分析和COX比例风险回归模型分析脑卒中的危险因素。  结果  376例受体的中位随访时间55个月,共有39例发生脑卒中,其累积发生率为10.4%。单因素分析发现,脑卒中组与非脑卒中组之间移植时年龄≥ 40岁、移植前透析时间≥ 12个月、估算肾小球滤过率(eGFR) < 30 mL/(min·1.73 m2)、高血压、糖尿病、脂代谢异常的发生率比较,差异均有统计学意义(均为P < 0.05)。多因素分析发现,影响肾移植受体脑卒中发生的独立危险因素为年龄≥40岁[风险比(HR)=1.110,95%可信区间(CI)为1.067~1.154,P=0.000]、移植前透析时间≥ 12个月(HR=1.044,95%CI为1.021~1.067,P=0.000)、eGFR < 30 mL/(min·1.73 m2)(HR=2.448,95%CI为1.197~5.005,P=0.014)。  结论  肾移植受体发生脑卒中的独立危险因素包括年龄≥ 40岁、移植前透析时间长和肾功能减退。

     

  • 表  1  两组危险因素的单因素分析结果

    Table  1.   The results of univariate analysis of risk factors for two groups [n(%)]

    变量 脑卒中组(n=39) 非脑卒中组(n=337) χ2 P
    性别
      男 23(59) 176(52) 0.639 0.499
      女 16(41) 161(48)
    年龄
       < 40岁 12(31) 265(79) 41.287.. 0.000
      ≥40岁 27(69) 072(21)
    移植前透析时间
       < 12个月 5(13) 198(59) 29.6890 0.000
      ≥12个月 34(87) 139(41)
    DGF 14(36) 085(25) 2.053 0.152
    eGFR < 30 mL/(min·1.73m2 25(64) 098(29) 19.4780 0.000
    糖尿病 24(62) 106(31) 13.986 0.000
    高血压 31(79) 197(58) 6.477 0.011
    高尿酸血症 21(54) 138(41) 2.382 0.123
    脂代谢异常 23(59) 131(39) 5.841 0.024
    服用FK506 27(69) 258(77) 1.023 0.312
    服用CsA 26(67) 210(62) 0.283 0.595
    下载: 导出CSV

    表  2  肾移植术后发生脑卒中危险因素的多因素分析结果

    Table  2.   The results of multivariate analysis of risk factors for cerebral apoplexy after renal transplantation

    危险因素 HR 95%CI P
    年龄≥40岁 1.110 1.067~1.154 0.000
    移植前透析时间≥12个月 1.044 1.021~1.067 0.000
    eGFR < 30 mL/(min·1.73m2 2.448 1.197~5.005 0.014
    脂代谢异常 1.583 0.762~3.291 0.218
    糖尿病 1.701 0.843~3.434 0.138
    高血压 1.622 0.370~3.703 0.251
    高尿酸血症 1.254 0.644~2.441 0.505
    DGF 1.432 0.694~2.954 0.331
    下载: 导出CSV
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出版历程
  • 收稿日期:  2017-11-23
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2018-03-15

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