CAJ | 학술논문

目的：探讨体重指数（BMI）对肾移植术后患者近期预后的影响。方法回顾性分析2009年3月至2013年3月在解放军第309医院器官移植研究所首次行肾移植手术的1041例成年患者的临床资料。根据中国常用成人肥胖与超重标准将纳入的患者分为4组：BMI <18.5 kg／m2组（消瘦组）112例，BMI 18.5～23.9 kg／m2组（正常组）606例，BMI 24.0～27.9 kg／m2组（超重组）250例， BMI≥28.0 kg／m2组（肥胖组）73例。观察与比较4组患者术后1年的移植物功能延迟恢复（DGF）、急性排斥反应（AR）发生率，以及计算1年人、肾存活率。采用单因素和多因素 Logistic 回归法分析BMI 与 DGF 发生的关系，以探讨不同 BMI 值对 DGF 的影响。结果随访1年，肥胖组 DGF 的发生率明显高于正常组和消瘦组（均为 P<0.05），但术后 AR 的发生率及术后1年人或肾存活率比较差异无统计学意义（均为 P ＞0.05）。单因素分析显示肥胖增加肾移植术后发生 DGF 的风险（OR 为1.33， P <0.05）。多因素分析显示超重与肥胖均为肾移植术后发生 DGF 的独立危险因素（OR 分别为1.56、1.37，均为 P <0.05）。结论超重与肥胖增加术后 DGF 风险，但不增加术后 AR 发生率，亦不影响术后近期人、肾存活率。
목적：탐토체중지수（BMI）대신이식술후환자근기예후적영향。방법회고성분석2009년3월지2013년3월재해방군제309의원기관이식연구소수차행신이식수술적1041례성년환자적림상자료。근거중국상용성인비반여초중표준장납입적환자분위4조：BMI <18.5 kg／m2조（소수조）112례，BMI 18.5～23.9 kg／m2조（정상조）606례，BMI 24.0～27.9 kg／m2조（초중조）250례， BMI≥28.0 kg／m2조（비반조）73례。관찰여비교4조환자술후1년적이식물공능연지회복（DGF）、급성배척반응（AR）발생솔，이급계산1년인、신존활솔。채용단인소화다인소 Logistic 회귀법분석BMI 여 DGF 발생적관계，이탐토불동 BMI 치대 DGF 적영향。결과수방1년，비반조 DGF 적발생솔명현고우정상조화소수조（균위 P<0.05），단술후 AR 적발생솔급술후1년인혹신존활솔비교차이무통계학의의（균위 P ＞0.05）。단인소분석현시비반증가신이식술후발생 DGF 적풍험（OR 위1.33， P <0.05）。다인소분석현시초중여비반균위신이식술후발생 DGF 적독립위험인소（OR 분별위1.56、1.37，균위 P <0.05）。결론초중여비반증가술후 DGF 풍험，단불증가술후 AR 발생솔，역불영향술후근기인、신존활솔。
Objective To investigate the effect of body mass index (BMI)on short-term prognosis of patients after renal transplantation.Methods Clinical data of 1 041 adult patients undergoing the first renal transplantation in the Institute of Organ Transplantation of the 309 th Hospital of People's Liberation Army from March 2009 to March 201 3 were retrospectively studied.According to the Adult Obesity and Overweight Standard commonly used in China,these patients were divided into 4 groups:112 patients in BMI <1 8.5 kg/m2 group (emaciation group),606 patients in BMI 1 8.5-23.9 kg/m2 group (normal group),250 patients in BMI 24.0-27.9 kg/m2 group (overweight group)and 73 patients in BMI≥28.0 kg/m2 group (obesity group).The incidence of delayed graft function (DGF)and acute rejection (AR)of the 4 groups one year after renal transplantation were observed and compared.One-year patient and graft survival rates were calculated.The relationship between BMI and DGF was studied by univariate and multivariate Logistic regression analysis to investigate the effect of different BMI on DGF.Results After the follow-up for one year,the incidence of DGF in the obesity group was significantly higher than that in the emaciation group and the normal group(both in P <0.05).The difference in the incidence of acute rejection one year after renal transplantation as well as one-year patient or graft survival rate had no statistical significance (all in P >0.05).Univariate analysis showed that obesity increased the risk of DGF after renal transplantation (OR was 1 .33,P <0.05).Multivariate analysis showed that both overweight and obesity were independent risk factors of DGF after renal transplantation (OR was respectively 1 .56 and 1 .37,both in P <0.05).Conclusions Overweight and obesity increases the risk of DGF after renal transplantation,but do not increase the incidence of AR after renal transplantation and do no influence short-term patient and graft survival rates after renal transplantation.