CAJ | 학술논문

背景:目前,活体肾脏捐赠的数量在全国乃至全世界范围内增长,因此,保障供者安全在亲体肾移植中占有重要地位.如何准确诊断移植供者可能存在的肾脏疾病,以指导供者手术后潜在肾脏病治疗和肾功能保护成为亲体肾移植后保障供者安全的重要课题.目的:建立一种对供者捐肾前的临床资料与组织学异常情况间相关性的评价方法.方法:对解放军南京军区福州总医院2008-02/2009-11所有亲属肾移植的相关数据做回顾件分析,于供肾血管离断并灌注完成后进行穿刺.用零点肾穿的方法评估下列病变:间质纤维化,小管萎缩,微小动脉透明变性,肾小球系膜增生和肾小球硬化.移植前的统计数据包括:体质量,体质量指数,收缩压,舒张压,血清肌酸酐,肾小球滤过率和蛋白尿.结果与结论:62例供者术前检查均未发现明显肾脏疾病征象,零点肾穿活检发现肾脏病理改变28例,其中间质纤维化与收缩压和肌酐清除率,肾小管萎缩与舒张压和尿蛋白,小动脉透明样变与肌酐和肾小球滤过率,肾小球系膜增生和体质量指数具有弱相关性,肾小球硬化与其他变量均无相关性.
배경:목전,활체신장연증적수량재전국내지전세계범위내증장,인차,보장공자안전재친체신이식중점유중요지위.여하준학진단이식공자가능존재적신장질병,이지도공자수술후잠재신장병치료화신공능보호성위친체신이식후보장공자안전적중요과제.목적:건립일충대공자연신전적림상자료여조직학이상정황간상관성적평개방법.방법:대해방군남경군구복주총의원2008-02/2009-11소유친속신이식적상관수거주회고건분석,우공신혈관리단병관주완성후진행천자.용영점신천적방법평고하렬병변:간질섬유화,소관위축,미소동맥투명변성,신소구계막증생화신소구경화.이식전적통계수거포괄:체질량,체질량지수,수축압,서장압,혈청기산항,신소구려과솔화단백뇨.결과여결론:62례공자술전검사균미발현명현신장질병정상,영점신천활검발현신장병리개변28례,기중간질섬유화여수축압화기항청제솔,신소관위축여서장압화뇨단백,소동맥투명양변여기항화신소구려과솔,신소구계막증생화체질량지수구유약상관성,신소구경화여기타변량균무상관성.
BACKGROUND: The number of living renal donation has increased in China and abroad, thus, it is important to guarantee the safety of donors. How to accurately diagnose potential renal disease and provide guidance plays an import role in protecting safety of living renal donors.OBJECTIVE: To establish an evaluation method for analyzing the correlation between histological abnormalities and clinical predonation parameters.METHODS: The related data on renal transplantation of Fuzhou general Hospital of Nanjing Military Area Command of Chinese PLA were retrospectively reviewed. Paracentesis were performed when the vessels of kidney were mutilated and perfusions were finished. Time-zero renal biopsy was evaluated for following pathological changes: interstitial fibrosis, tubularatrophy, arteriolar hyalinosis, mesangial proliferation, and glomerulosclerosis. Predonation data were demography, body weight, body mass index' systolic/diastolic blood pressure, serum creatinine, glomerular filtration rate, and proteinuria.RESULTS AND CONCLUSION: There were no signs of kidney disease in preoperative examination of all the 62 patients, time-zero renal biopsy found there were 28 donors with histological changes, interstitial fibrosis with age and serum creatinine, tubularatrophy with diastolic blood pressure and protein excretion rate, arteriolar hyalinosis with serum creatinine and glomerular filtration rate, mesangial proliferation only with body mass index, and finally the presence of glomerulosclerosis did not correlate with any variable.