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高血压是肾移植术后一个常见和重要的并发症,它的存在直接影响到移植肾的功能和远期预后,肾移植术后高血压原因复杂,有一些机理目前尚不明了,它既不是肾血管性高血压,也不属肾实质性高血压,在整个肾性高血压中自成一类。一、肾移植术后高血压的发生率及其对移植肾的影响肾移植术后高血压的发生率各家报道不一,在20%～80%之间,通常为60%～70%。当然,在肾移植后的不同时期高血压的发生是不同的。肾移植后最初几个月高血压的发生率较高,以后呈逐渐降低趋势。此类高血压术身可有很大的波动性,不少病人初期有明显的高血压,后期血压逐渐恢复正常,另一部分病人初期血压正常,后期反而出现高血压。高血压的发生与术前是否伴有高血压史有关,如果术前就有高血压的往往术后会持续存在。此外,临床和动物实验业已证明接受高血压患者提供的肾脏,可导致术后发生高血压。伴与不伴有高血压直接影响肾移植患者的预后。术后血压三正常者移植肾的存活率明显高于伴高血压者。在术后最初两年,伴难治性高血压者其血清肌酐水平明显高于血压正常者,提示这些病例可能在移植初期肾功能就不健全。
Hypertension is a common and important complication after renal transplantation. Its existence has a direct impact on the function and long-term prognosis of renal transplant. The causes of hypertension after renal transplantation are complex. There are some mechanisms that are not yet clear. It is neither Renal vascular hypertension, nor is renal parenchymal hypertension, in the entire renal hypertension in a category. First, the incidence of posttransplantation of hypertension and its impact on renal transplant The incidence of post-renal hypertension after various reports vary between 20% to 80%, usually 60% to 70%. Of course, the incidence of hypertension is different at different times after kidney transplantation. The incidence of hypertension was higher in the first few months after kidney transplantation and gradually decreased afterwards. Such hypertensive patients can have great volatility, many patients had significant early hypertension, postoperative blood pressure gradually returned to normal, the other part of the initial normal blood pressure, but later appeared antihypertensive. Hypertension and preoperative occurrence of hypertension associated with a history of preoperative if there is often postoperative hypertension will persist. In addition, clinical and animal experiments have shown that the kidneys provided to hypertensive patients can lead to postoperative hypertension. With and without hypertension directly affect the prognosis of renal transplant patients. Three normal postoperative blood pressure graft survival was significantly higher than those with hypertension. In the first two years after surgery, patients with refractory hypertension had significantly higher serum creatinine levels than those with normotension, suggesting that these patients may have impaired renal function early in the transplant.