中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2009年
3期
172-175
,共4页
王琳%高振利%王科%柳东夫%奉友刚%杨典东%王辉%门昌平%王建明%WANG Jian-ming
王琳%高振利%王科%柳東伕%奉友剛%楊典東%王輝%門昌平%王建明%WANG Jian-ming
왕림%고진리%왕과%류동부%봉우강%양전동%왕휘%문창평%왕건명%WANG Jian-ming
肾移植%体重指数%慢性移植物肾病
腎移植%體重指數%慢性移植物腎病
신이식%체중지수%만성이식물신병
Kidney transplantation%Body mass index%Chronic allograft nephropathy
目的 研究肾移植患者术后1年体质量指数(BMI)对慢性移植物肾病(CAN)的影响.方法 肾移植术受者564例,依据BMI分3组:①I组:18.5≤BMI≤25(正常);②Ⅱ组:25＜BMI≤30(超重);③Ⅲ组,BMI＞30(肥胖).比较各组术后高血压、糖尿病、CAN等发生情况.结果 各组术后1年的BMI均较术前增加,其中Ⅱ、Ⅲ组与术前比较差异有统计学意义(P值分别＜0.05和0.01).3组CAN发生率分别为34.9%(128/367)、38.4%(48/125)、43.1%(31/72),术后1年随着BMI的升高而增加,Ⅲ组与Ⅰ组比较差异有统计学意义(P＜0.05);高血压、糖尿病和高脂血症的发病率随着BMI升高而增加,Ⅲ组与Ⅰ组高血压、糖尿病和高脂血症的发生率分别为30.6%(22/72)和21.0%(77/367)、26.4%(19/72)和15.8%(58/367)、29.2%(21/72)和18.1%(66/367),2组比较差异有统计学意义(P＜0.05);急性排斥反应发生率:Ⅰ组26.4%(97/367),Ⅱ组25.6%(32/125),Ⅲ组22.2%(16/72),3组之间急性排斥反应发生率比较差异无统计学意义(P＞0.05).结论 肾移植患者术后1年BMI和CAN的发生密切相关,通过饮食控制、适当体育锻炼、免疫抑制剂减量等措施可以控制移植后BMI,进而最大限度降低CAN的发生.
目的 研究腎移植患者術後1年體質量指數(BMI)對慢性移植物腎病(CAN)的影響.方法 腎移植術受者564例,依據BMI分3組:①I組:18.5≤BMI≤25(正常);②Ⅱ組:25＜BMI≤30(超重);③Ⅲ組,BMI＞30(肥胖).比較各組術後高血壓、糖尿病、CAN等髮生情況.結果 各組術後1年的BMI均較術前增加,其中Ⅱ、Ⅲ組與術前比較差異有統計學意義(P值分彆＜0.05和0.01).3組CAN髮生率分彆為34.9%(128/367)、38.4%(48/125)、43.1%(31/72),術後1年隨著BMI的升高而增加,Ⅲ組與Ⅰ組比較差異有統計學意義(P＜0.05);高血壓、糖尿病和高脂血癥的髮病率隨著BMI升高而增加,Ⅲ組與Ⅰ組高血壓、糖尿病和高脂血癥的髮生率分彆為30.6%(22/72)和21.0%(77/367)、26.4%(19/72)和15.8%(58/367)、29.2%(21/72)和18.1%(66/367),2組比較差異有統計學意義(P＜0.05);急性排斥反應髮生率:Ⅰ組26.4%(97/367),Ⅱ組25.6%(32/125),Ⅲ組22.2%(16/72),3組之間急性排斥反應髮生率比較差異無統計學意義(P＞0.05).結論 腎移植患者術後1年BMI和CAN的髮生密切相關,通過飲食控製、適噹體育鍛煉、免疫抑製劑減量等措施可以控製移植後BMI,進而最大限度降低CAN的髮生.
목적 연구신이식환자술후1년체질량지수(BMI)대만성이식물신병(CAN)적영향.방법 신이식술수자564례,의거BMI분3조:①I조:18.5≤BMI≤25(정상);②Ⅱ조:25＜BMI≤30(초중);③Ⅲ조,BMI＞30(비반).비교각조술후고혈압、당뇨병、CAN등발생정황.결과 각조술후1년적BMI균교술전증가,기중Ⅱ、Ⅲ조여술전비교차이유통계학의의(P치분별＜0.05화0.01).3조CAN발생솔분별위34.9%(128/367)、38.4%(48/125)、43.1%(31/72),술후1년수착BMI적승고이증가,Ⅲ조여Ⅰ조비교차이유통계학의의(P＜0.05);고혈압、당뇨병화고지혈증적발병솔수착BMI승고이증가,Ⅲ조여Ⅰ조고혈압、당뇨병화고지혈증적발생솔분별위30.6%(22/72)화21.0%(77/367)、26.4%(19/72)화15.8%(58/367)、29.2%(21/72)화18.1%(66/367),2조비교차이유통계학의의(P＜0.05);급성배척반응발생솔:Ⅰ조26.4%(97/367),Ⅱ조25.6%(32/125),Ⅲ조22.2%(16/72),3조지간급성배척반응발생솔비교차이무통계학의의(P＞0.05).결론 신이식환자술후1년BMI화CAN적발생밀절상관,통과음식공제、괄당체육단련、면역억제제감량등조시가이공제이식후BMI,진이최대한도강저CAN적발생.
Objective To evaluate the effect of body mass index(BMI)at 1 year after renal transplantation on chronic allograft nephropathy(CAN).Methods 564 patients received kidney transplants between June 1997 and March 2005 were grouped according to their body mass index (BMI)at 1 year after transplantation into three groups;group Ⅰ,BMI more than 18.5 and less than or equal to 25(normal weight);group Ⅱ,BMI greater than 25 and less than or equal to 30(overweight);and group Ⅲ,BMI greater than 30(obese).All selected patients were retrospectively studied.Results One year post transplant BMIs were more than that of preoperation in all groups.The BMIs in Group Ⅱ and Ⅲ were significantly increased than before operation(P＜0.05 and P＜0.01).The CAN incidence rates in 3 groups were 34.9%(128/367),38.4%(48/125)and 43.1%(31/72),respectively.There was a statistically significant difference in CAN between group Ⅰ andⅢ(P＜0.05).With the increase of one-year post transplant BMI,hypertension.diabetes mellitus and hyper-lipidemia rates increased in group Ⅲ and Ⅰ,30.6%(22/72)and 21.0%(77/367),26.4%(19/72)and 15.8%(58/367),29.2%(21/72)and 18.1%(66/367)respectively.There was a statistically sig-nificant difference in one-year post transplant BMI,hypertension,diabetes mellitus and hyperlipidemiarates between group Ⅲ and I(P＜O.05).Acute rejection rate was 26.4%(97/367),25.6%(3z/125),22.2%(16/72)respectively in these three groups.There was no difference in acute rejection rate among these three groups. Conclusions1 year BMI after kidney transplantation has a strong association with CAN.Controlling diet,proper exercises and decrease of immunosuppressiVe agent could help in control of BMI and then decreases the CAN incidence.
