CAJ | 학술논문

目的分析与探讨肾移植术后红细胞增多症(PTE)与高钙血症的相关性.方法回顾性分析2012年1月至2014年1月169例接受肾移植、且术后移植肾功能恢复正常受者的临床资料.169例受者中,男性121例,女性48例,所有受者均采用环孢素A(或他克莫司)+吗替麦考酚酯+醋酸泼尼松的三联免疫抑制方案,术后随访时间(20.1±15.9)个月.结果随访期间,48例(28.4％)受者发生PTE,33例(19.5％)发生高钙血症.发生高钙血症受者中17例(51.5％)发生PTE,非高钙血症受者中31例(22.8％)发生PTE,二者的PTE发生率比较,差异有统计学意义(P＜0.001),PTE与高钙血症具有相关性.PTE组受者的血钙水平为(2.46±0.1)mmol/L,显著高于非PTE组受者的(2.39±0.1)mmol/L(P=0.003).PTE组受者高钙血症发生率为35.4％(17/48),显著高于非PTE组的13.2％(16/121),差异有统计学意义(P＜0.001).简单线性回归模型分析结果显示,术后血钙离子浓度是血红蛋白水平的独立预测因子(P＜0.01);多重线性回归模型分析结果显示,血钙离子浓度仍然是血红蛋白水平的显著预测因子(P＜0.001);多因素Logistic回归模型分析结果显示,高钙血症是术后发生PTE的独立危险因素(相对危险系数=4.837,95％可信区间为1.447～16.173,P=0.01),估算肾小球滤过率(eGFR)也与PTE发生相关(P=0.012),而男性发生PTE的相对危险度为女性的4.373倍(P＜0.05).高钙血症受者发生PTE的几率比血钙正常受者高大约5倍.结论肾移植术后PTE与高钙血症存在明显的相关关系,高钙血症可能增加PTE的发生风险.
목적 분석여탐토신이식술후홍세포증다증(PTE)여고개혈증적상관성.방법 회고성분석2012년1월지2014년1월169례접수신이식、차술후이식신공능회복정상수자적림상자료.169례수자중,남성121례,녀성48례,소유수자균채용배포소A(혹타극막사)+마체맥고분지+작산발니송적삼련면역억제방안,술후수방시간(20.1±15.9)개월.결과 수방기간,48례(28.4％)수자발생PTE,33례(19.5％)발생고개혈증.발생고개혈증수자중17례(51.5％)발생PTE,비고개혈증수자중31례(22.8％)발생PTE,이자적PTE발생솔비교,차이유통계학의의(P＜0.001),PTE여고개혈증구유상관성.PTE조수자적혈개수평위(2.46±0.1)mmol/L,현저고우비PTE조수자적(2.39±0.1)mmol/L(P=0.003).PTE조수자고개혈증발생솔위35.4％(17/48),현저고우비PTE조적13.2％(16/121),차이유통계학의의(P＜0.001).간단선성회귀모형분석결과현시,술후혈개리자농도시혈홍단백수평적독립예측인자(P＜0.01);다중선성회귀모형분석결과현시,혈개리자농도잉연시혈홍단백수평적현저예측인자(P＜0.001);다인소Logistic회귀모형분석결과현시,고개혈증시술후발생PTE적독립위험인소(상대위험계수=4.837,95％가신구간위1.447～16.173,P=0.01),고산신소구려과솔(eGFR)야여PTE발생상관(P=0.012),이남성발생PTE적상대위험도위녀성적4.373배(P＜0.05).고개혈증수자발생PTE적궤솔비혈개정상수자고대약5배.결론 신이식술후PTE여고개혈증존재명현적상관관계,고개혈증가능증가PTE적발생풍험.
Objective To examine the relationship between hypercalcemia (HC) and the development of posttransplant erythrocytosis (PTE).Method 169 patients with normal graft function who underwent renal transplantation between January 1, 2012 and January 1, 2014 in 309th Hospital of PLA were retrospectively reviewed.Result 169 patients with normal graft function who underwent kidney transplantation for the first time in 309th Hospital from January 1, 2012 to January 1, 2014 were enrolled, including 121 males and 48 females.During the follow-up period, PTE appeared in 48 (28.4％) patients.Thirty-three (19.5％) patients developed HC, PTE occurred in 17/33 (51.5％) patients with HC, and in 31/136 (22.8％) patients without HC.PTE and HC were highly correlated (P＜0.001).Serum calcium levels tended to increase in patients with PTE, but significantly decreased in patients without PTE.HC patients had a higher probability of PTE (51.5％ vs.22.8％;P＜0.001).Similarly, HC was more common among patients with PTE compared with patients without PTE (35.4％ vs.13.2％;P＜0.001).Simple linear regression analysis showed that calcium concentration was independent predictor of hemoglobin levels (P＜0.01).In multivariate analysis, multiple linear regression model showed that the calcium concentration was still a significant predictor of hemoglobin levels (P＜0.001).Multivariate logistic regression analysis showed that the occurrence of HC was an independent risk factor of PTE (P =0.01).Estimated glomerular filtration rate was also associated with PTE (P =0.012).As compared with women, the relative risk of men who had PTE was 4.373 times (P＜0.05).The risk of PTE in patients with HC was about five times higher than in patients with normal blood calcium.Conclusion HC is associated with PTE.HC may lead to the increased PTE in renal transplant recipients.