体重指数对肾移植近期预后的影响:附单中心1041例报告

Effect of body mass index on short-term prognosis of renal transplantation: a report of 1 041 cases in a single center

    摘要
  • 摘要:
      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1 041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。

     

    Abstract:
      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 309th Hospital of People's Liberation Army from March 2009 to March 2013 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 < 18.5 kg/m2 group (emaciation group), 606 patients in BMI 18.5-23.9 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.

     

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