CAJ | 학술논문

背景：最近研究表明，肾移植后贫血是移植后心血管疾病的重要危险因素，并且是患者死亡的独立预测指标。目的：探讨肾移植受者移植后贫血的患病率、处理方案以及危险因素。方法：回顾性分析154例在解放军南京军区福州总医院泌尿外科随访的尸体肾移植受者病例资料。采集入选患者在肾移植住院期间以及移植后1，2，3，4，5年的血常规、血生化检查结果并进行分析。结果与结论：患者肾移植当时以及其后5年贫血的患病率分别为45.5%，10.7%，9.6%，14.8%，13.5%及19.6%。患者在5年内至少出现一次贫血，其中42%经历过贫血的再发。相关分析发现血红蛋白水平与移植肾功能相关。不同性别、年龄、免疫抑制方案以及是否使用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂与贫血的患病率不存在相关性。二元Logistic回归分析显示移植后1年血肌酐、尿素氮与贫血诊断相关，而移植后5年时仅与血肌酐相关。尽管铁剂药物使用比较普遍，但促红细胞生成素在移植肾功能不全的贫血患者中却很少应用。提示肾移植后贫血患病率较高，移植肾功能不全是其发病的主要危险因素。
배경：최근연구표명，신이식후빈혈시이식후심혈관질병적중요위험인소，병차시환자사망적독립예측지표。목적：탐토신이식수자이식후빈혈적환병솔、처리방안이급위험인소。방법：회고성분석154례재해방군남경군구복주총의원비뇨외과수방적시체신이식수자병례자료。채집입선환자재신이식주원기간이급이식후1，2，3，4，5년적혈상규、혈생화검사결과병진행분석。결과여결론：환자신이식당시이급기후5년빈혈적환병솔분별위45.5%，10.7%，9.6%，14.8%，13.5%급19.6%。환자재5년내지소출현일차빈혈，기중42%경력과빈혈적재발。상관분석발현혈홍단백수평여이식신공능상관。불동성별、년령、면역억제방안이급시부사용혈관긴장소전환매억제제혹혈관긴장소수체조체제여빈혈적환병솔불존재상관성。이원Logistic회귀분석현시이식후1년혈기항、뇨소담여빈혈진단상관，이이식후5년시부여혈기항상관。진관철제약물사용비교보편，단촉홍세포생성소재이식신공능불전적빈혈환자중각흔소응용。제시신이식후빈혈환병솔교고，이식신공능불전시기발병적주요위험인소。
BACKGROUND:Recent studies have shown that anemia after renal transplantation is an important risk factor for cardiovascular disease after transplantation, as wel as the independent predictor of death. OBJECTIVE:To explore the prevalence, processing and risk factors of anemia after renal transplantation. METHODS:The data of 154 cases renal transplantation recipients who fol owed-up in the Department of Urology, Fuzhou General Hospital of Nanjing Military Command were retrospectively analyzed. The blood routine and blood biochemistry of the renal transplantation patients were col ected for analysis during hospitalization and 1, 2, 3, 4 and 5 years after transplantation. RESULTS AND CONCLUSION:The prevalence of anemia during transplantation and the subsequent 5 years after transplantation were 45.5%, 10.7%, 9.6%, 14.8%, 13.5%and 19.6%, respectively. Patients had anemia at least once in five years, and 42%of the patients experienced recurrence. Relative analysis showed that hemoglobin levels were associated with function of transplanted kidney. Different genders, ages and the using of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers or not has no correlation with the prevalence of anemia. Binary Logistic regression analysis showed that serum creatinine and blood urea nitrogen levels at 1 year after transplantation were correlated with the diagnosis of anemia, and only associated with serum creatinine level at 5 years after transplantation. Iron drug is relatively common, but erythropoietin is rarely applied in the anemia patients with transplant renal insufficiency. The prevalence of anemia after renal transplantation is high, and transplant renal insufficiency is a major risk factor for the disease.