CAJ | 학술논문

目的：探讨活体肾移植供肾肾小球滤过率（GFR）对术后移植肾功能恢复的影响。方法回顾性分析2009年至2013年在昆明医科大学第一附属医院器官移植中心接受活体供肾移植的108对供受者的临床资料。按供肾 GFR 数值大小将研究对象分为 G1组（GFR ＜40 ml／min）、G2组（GFR 40～45 ml／min）、G3组（GFR 46～50 ml／min）及 G4组（GFR ＞50 ml／min）。比较各组受者术后1周、2周、3周、1个月、3个月、6个月及1年的血清肌酐（Scr）的变化情况，以及术后1年的人及肾存活情况。结果与 G1组比较，G2、G3、G4组术后2周、3周、1个月的 Scr 值较低，差异有统计学意义（均为 P ＜0.05）。术后1年内人、肾存活情况，G1组超急性排斥反应致移植肾失功1例、重症肺部感染死亡1例；G2组因急性排斥反应导致移植肾失功1例；G3组死于重症肺部感染者1例；G4组1例死于重症肺部感染；其余患者在随访期间人、肾均存活。结论活体肾移植供肾GFR 值低对术后移植肾早期（1个月内）肾功能恢复有一定影响。
목적：탐토활체신이식공신신소구려과솔（GFR）대술후이식신공능회복적영향。방법회고성분석2009년지2013년재곤명의과대학제일부속의원기관이식중심접수활체공신이식적108대공수자적림상자료。안공신 GFR 수치대소장연구대상분위 G1조（GFR ＜40 ml／min）、G2조（GFR 40～45 ml／min）、G3조（GFR 46～50 ml／min）급 G4조（GFR ＞50 ml／min）。비교각조수자술후1주、2주、3주、1개월、3개월、6개월급1년적혈청기항（Scr）적변화정황，이급술후1년적인급신존활정황。결과여 G1조비교，G2、G3、G4조술후2주、3주、1개월적 Scr 치교저，차이유통계학의의（균위 P ＜0.05）。술후1년내인、신존활정황，G1조초급성배척반응치이식신실공1례、중증폐부감염사망1례；G2조인급성배척반응도치이식신실공1례；G3조사우중증폐부감염자1례；G4조1례사우중증폐부감염；기여환자재수방기간인、신균존활。결론활체신이식공신GFR 치저대술후이식신조기（1개월내）신공능회복유일정영향。
Objective To investigate the influence of glomerular filtration rate (GFR)of living donor on recovery of graft function after transplantation.Methods Clinical data of 108 pairs of donors and recipients undergoing living donor renal transplantation at the Organ Transplantation Center of First Affiliated Hospital of Kunming Medical University from 2009 to 2013 were retrospectively studied.The objects were divided into G1 group (GFR <40 ml/min),G2 group(GFR 40 ~45 ml/min),G3 group(GFR 46 ~50 ml/min)and G4 group (GFR >50 ml/min)according to GFR of the donor kidneys.Changes in serum creatinine (Scr)at 1 week,2 weeks,3 weeks,1 month,3 months,6 months and 1 year after transplantation as well as survival conditions of patient and kidney within 1 year after transplantation of each group were compared.Results Compared with G1 group,Scr at 2 weeks,3 weeks,1 month after transplantation was lower in G2 group,G3 group and G4 group,and the difference had statistical significance (all in P <0.05).As for survival conditions of patient and kidney within 1 year after transplantation,one patient in G1 group developed graft failure due to hyperacute rejection and one patient in G1 group died of severe pulmonary infection.One patient in G2 group developed graft failure due to acute rejection.One patient in G3 group died of severe pulmonary infection.One patient in G4 group died of severe pulmonary infection. Other patients and grafts survived during the follow-up.Conclusions Low GFR of living kidney donor has certain influence on recovery of graft function in the early stage (within one month)after renal transplantation.