127例肾移植受者术后预后相关因素的回顾性分析

Yuanyuan Gao , Xue Yu , Xiao Feng , Ya Zhang
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引用次数: 1

摘要

目的目前,肾移植受者比一般人群更容易发生术后感染、排斥反应或意外死亡。本研究旨在探讨某些实验室检查是否可以预测肾移植围手术期患者的术后身体恢复情况。方法对2013年1月至2017年11月苏州大学第一附属医院127例肾移植患者进行回顾性队列分析。将这些患者分为术后感染组、意外死亡组和无事件组,测定其血小板(PLT)、CD4+/CD8+、胱抑素C (CysC)、术前和术后血清肌酐(Scr)。结果127例患者(中位年龄38.7 ± 5.4 y,范围18-65 y)中,61例(48%)患者在肾移植术后前3个月内发生医院获得性感染。此外,高血压并发症与术后患者状态相关(P < 0.01)。患者预后与血小板(PLT) (P = 0.27)、CD4+/CD8+ (P = 0.38)、胱抑素C (CysC) (P = 0.35)无关。然而,术后感染患者术前Scr和术后Scr均显著高于无事件患者(P = 0.002和P = 0.007)。结论高血压并发症可加重肾移植术后患者病情。此外,由于术前Scr和术后Scr均可预测肾移植患者的医院获得性感染,对于术前和术后Scr水平较高的患者,应适当延长预防性抗生素的使用时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors related to postoperative prognosis of kidney transplant recipients: A retrospective analysis of 127 patients

Objectives

At present, kidney transplant recipients are more likely to suffer from postoperative infection, rejection, or accidental death than general population. This study aims to discuss whether or not certain laboratory testings can predict the postoperative physical recovery in the perioperative period of renal transplant.

Methods

This paper is a retrospective cohort review of 127 patients who received kidney transplantation from January 2013 to November 2017 at the First Affiliated Hospital of Soochow University, China. These patients were classified into three groups: postoperative infection, accidental death and event-free groups, and their Platelet (PLT), CD4+/CD8+, Cystatin C (CysC), pre- and post-operative serum creatinine (Scr) were determinated.

Results

Among the 127 patients (median age 38.7 ± 5.4 y, range 18–65 y), 61 patients (48%) suffered from hospital acquired infection during the first three months after kidney transplantation. Furthermore, the hypertension complications were found to be associated with the postoperative patient status (P < 0.01). The prognosis of patients was not related to Platelet (PLT) (P = 0.27), CD4+/CD8+ (P = 0.38) and Cystatin C (CysC) (P = 0.35). However, both preoperative Scr and postoperative Scr were significant higher in patients who suffered from postoperative infection than that in event free patients (P = 0.002 and P = 0.007, respectively).

Conclusions

It was found that the hypertension complications could aggravate patient status after renal transplant. Furthermore, because both preoperative Scr and postoperative Scr can be used to predict the hospital acquired infection of kidney transplant patients, the duration of taking prophylactic antibiotics for patients with higher levels of pre- and post-operative Scr should be properly extended.

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