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(e GFR)<30 m L/(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)、e GFR<30 m L/(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。
Objective To analyze the risk factors for cerebral apoplexy in the recipients after renal transplantation. Methods Clinical data of 376 renal transplant recipients who were followed up regularly were retrospectively analyzed. The recipients were divided into cerebral apoplexy group（39 cases） and non-cerebral apoplexy group（337 cases） according to the occurrence of cerebral apoplexy. The risk factors of cerebral apoplexy were analyzed using single factor analysis and COX proportional hazards regression model. Results The 376 recipients were followed up for a median duration of 55 months, among whom 39 recipients suffered from cerebral apoplexy, with a cumulative incidence of 10.4%. Single factor analysis indicated that there were significant differences in age ≥40 years old at transplantation, duration of dialysis ≥12 months before transplantation, estimated glomerular filtration rate（e GFR） 30 m L/（min·1.73 m2）, incidence of hypertension, diabetes and dyslipidemia between cerebral apoplexy group and non-cerebral apoplexy group（all P〈0.05）. Multivariate analysis indicated that the independent risk factors for cerebral apoplexy occurred in the recipients after renal transplantation were age ≥40 years old [hazard ratio（HR） =1.110, 95% confidence interval（CI）=1.067-1.154, P=0.000], duration of dialysis ≥12 months before transplantation（HR=1.044, 95%CI=1.021-1.067, P=0.000） and e GFR30 m L/（min·1.73 m2）（HR=2.448, 95%CI=1.197-5.005, P=0.014）. Conclusions The independent risk factors for cerebral apoplexy in the recipients after renal transplantation include age ≥ 40 years old, long duration of dialysis before transplantation and renal insufficiency.
作者
杜鹏
张蓬杰
段斌
陈瑞
丁通
Du Peng;Zhang Pengjie;Duan Bin;Chen Rui;Ding Tong.(Kidney Disease and Dialysis Center, Shaanxi Provincial People＇s Hospital Xi＇an 710068, China)
出处
《器官移植》
CAS
CSCD
北大核心
2018年第2期142-146,共5页
Organ Transplantation
基金
陕西省科技计划项目(2012SF2-12)
