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目的探讨同种肾移植受者术后远期发生贫血的危险因素。方法93例同种肾移植受者按照贫血与否分为贫血组和非贫血组,探讨免疫抑制剂、降压药物、移植肾功能以及其他伴随疾病对肾移植术后远期贫血的影响,同时检测两组血清促红细胞生成素的水平。结果贫血组女性受者,联合应用西罗莫司(SRL)和霉酚酸酯(MMF),应用血管紧张素转化酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)降压药物,血肌酐大于120μmol/L,慢性移植肾小球硬化,以及伴有巨细胞病毒(CMV)感染或者上消化道溃疡的肾移植受者均较非贫血组显著增多(P<0.05)。贫血组促红细胞生成素(EPO)水平显著低于非贫血组(P<0.05)。结论女性患者、联合SRL和MMF治疗、应用ACEI类或ARB类降压药,血肌酐大于120μmol/L,慢性移植肾小球硬化,以及伴有巨细胞病毒(CMV)感染或上消化道溃疡等疾病是肾移植术后远期发生贫血的危险因素。
Objective To investigate the risk factors of long-term anemia in allograft recipients. Methods Ninety-three recipients of the same type of kidney transplant were divided into anemia group and non-anemia group according to the degree of anemia. The effects of immunosuppressive agents, antihypertensive drugs, renal graft function and other associated diseases on long-term anemia after renal transplantation were studied. The levels of serum erythropoietin in both groups were detected. Results Female subjects with anemia were treated with sirolimus and mycophenolate mofetil (MMF) in combination with angiotensin-converting enzyme inhibitor (ACEI) or angiotensin Ⅱ receptor blocker (ARB) Drugs, serum creatinine greater than 120μmol / L, chronic graft glomerulosclerosis, and cytomegalovirus (CMV) infection or upper gastrointestinal ulcer in renal transplant recipients were significantly increased compared with non-anemia group (P <0.05). Erythropoietin (EPO) levels in anemia group were significantly lower than those in non-anemia group (P <0.05). Conclusions Female patients, combined with SRL and MMF treatment, should be given ACEI or ARB antihypertensive drugs with serum creatinine over 120 μmol / L, chronic graft glomerulosclerosis, CMV infection or upper gastrointestinal ulcer Disease is a risk factor for long-term anemia after kidney transplantation.