摘要
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。
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 and Ⅲ （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 significant difference in one-year post transplant BMI, hypertension, diabetes mellitus and hyperlipidemia rates between group Ⅲ and Ⅰ（P〈0. 05）. Acute rejection rate was 26.4% （97/367）, 25.6% （32/ 125）,22.2% （16/72） respectively in these three groups. There was no difference in acute rejection rate among these three groups. Conclusions 1 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.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2009年第3期172-175,共4页
Chinese Journal of Urology
关键词
肾移植
体重指数
慢性移植物肾病
Kidney transplantation
Body mass index
Chronic allograft nephropathy
作者简介
通信作者：王科，Email：wangke6910@sina．com
