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背景:大量研究充分证实高血压、血管性肾硬化、慢性全身炎症反应都是移植肾慢性失功的重要诱因。高尿酸血症与原发性高血压及血管性肾硬化有关,并且可引起全身炎症反应,那么肾移植后高尿酸血症发病及病变程度是否对移植肾远期功能有影响呢?目的:实验首次探讨肾移植前后高尿酸血症及其病变程度对移植肾远期功能的影响。方法:选择解放军第一八一医院全军肾移植与透析治疗中心肾移植后肾功能恢复正常患者216例,男性146例,年龄(40.98±11.09)岁;女性70例,年龄(40.01±11.62)岁。为比较移植前后高尿酸血症对移植肾远期功能的影响,将病例分为4组:正常组、移植前高尿酸血症组、移植后高尿酸血症组、移植前后均高组。为比较移植后不同血清尿酸水平对移植肾远期功能的影响,将病例分为3组:血尿酸水平正常组、血尿酸水平高于正常但<500μmol/L组、血尿酸水平>500μmol/L组。观察移植前后高尿酸血症对移植肾远期功能的影响;移植后不同程度增高血尿酸水平对移植肾远期功能的影响。结果与结论:移植前男性患者高尿酸血症患病率为34.2%,女性患者为37.7%;移植后30d肾功能恢复正常时,男性患者高尿酸血症患病率为36.2%,女性患者为42.4%,与移植前相比差异均无显著性意义。女性患者肾移植后高尿酸血症患病率高于男性患者(P<0.05)。男女患者移植后血尿酸水平均高于移植前(P<0.01)。随访3年时,移植前血尿酸水平对患者远期血肌酐水平无显著影响(P>0.05),但移植后血尿酸水平持续增高者,远期血肌酐水平显著高于移植后血尿酸水平正常者。实验结果显示,肾移植后肾功能恢复良好患者的高尿酸血症患病率及程度均高于移植前,尤其是在女性患者。移植后尿酸持续增高患者远期移植肾功能不如移植后尿酸正常患者,提示移植后高尿酸血症可能是导致慢性移植肾失功的因素之一。
Background: A large number of studies have fully confirmed that hypertension, vascular nephrosclerosis and chronic systemic inflammatory response are all important inducing factors of chronic renal failure. Hyperuricemia and essential hypertension and vascular nephrosclerosis related, and can cause systemic inflammatory response, then the incidence of renal damage and hyperuricemia pathogenesis of long-term function of renal transplant it? Objective: Experiment For the first time before and after renal transplantation hyperuricemia and its degree of lesion on the long-term function of renal grafts. Methods: A total of 216 patients (146 male, 40.98 ± 11.09 years old) and 70 females (aged 40.01 ± 11.62) were enrolled in the Renal Transplantation and Dialysis Center of the PLA General Hospital of PLA. year old. To compare the effect of hyperuricemia before and after transplantation on long-term graft function, the patients were divided into 4 groups: normal group, pre-transplantation hyperuricemia group, post-transplant hyperuricemia group and high-grade group before and after transplantation. To compare the effect of different serum uric acid levels on the long-term graft function after transplantation, the patients were divided into 3 groups: normal blood uric acid level, serum uric acid level higher than normal but <500μmol / L group, blood uric acid level> 500μmol / L group. To observe the effect of hyperuricemia before and after transplantation on the long-term function of allografts. After transplantation, the levels of serum uric acid increased the long-term function of allografts. RESULTS AND CONCLUSION: The prevalence of hyperuricemia was 34.2% in male patients and 37.7% in female patients before transplantation. The prevalence of hyperuricemia in male patients was 36.2% at 30 days after transplantation, and the female patients were 42.4%, compared with before transplantation no significant difference. The prevalence of hyperuricemia in female patients after renal transplantation was higher than that in male patients (P <0.05). The serum uric acid levels in both male and female patients after transplantation were higher than those before transplantation (P <0.01). After 3 years of follow-up, the serum uric acid level before transplantation had no significant effect on the long-term serum creatinine level (P> 0.05). However, the serum uric acid level continued to increase after transplantation, and the long-term serum creatinine level was significantly higher than that after transplantation By. The experimental results showed that the prevalence and degree of hyperuricemia in patients with good renal function recovered after renal transplantation were higher than those before transplantation, especially in female patients. Uric acid continued to increase after transplantation in patients with long-term renal transplant function than normal uric acid after transplantation, suggesting that post-transplant hyperuricemia may lead to chronic graft failure one of the factors.