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肺移植受者术后肺功能的变化特点

蔡宇航, 练巧燕, 王晓华, 等. 肺移植受者术后肺功能的变化特点[J]. 器官移植, 2023, 14(5): 676-682. doi: 10.3969/j.issn.1674-7445.2023092
引用本文: 蔡宇航, 练巧燕, 王晓华, 等. 肺移植受者术后肺功能的变化特点[J]. 器官移植, 2023, 14(5): 676-682. doi: 10.3969/j.issn.1674-7445.2023092
Cai Yuhang, Lian Qiaoyan, Wang Xiaohua, et al. Changes of postoperative pulmonary function in lung transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(5): 676-682. doi: 10.3969/j.issn.1674-7445.2023092
Citation: Cai Yuhang, Lian Qiaoyan, Wang Xiaohua, et al. Changes of postoperative pulmonary function in lung transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(5): 676-682. doi: 10.3969/j.issn.1674-7445.2023092

肺移植受者术后肺功能的变化特点

doi: 10.3969/j.issn.1674-7445.2023092
基金项目: 广东省自然科学基金(2022A1515012216);广州呼吸健康研究所基金(2019GIRHZ04);广东省钟南山医学基金(ZNSA-2020013);广州呼吸健康研究院基础研究计划(202201020371)
详细信息
    作者简介:
    通讯作者:

    巨春蓉(ORCID:0000-0001-9041-874X),主任医师,教授,博士研究生导师,研究方向为终末期肺疾病肺移植术前评估与术后并发症诊治,Email:juchunrong@126.com

  • 中图分类号: R617, R563

Changes of postoperative pulmonary function in lung transplant recipients

More Information
  • 摘要:   目的   分析肺移植受者术后肺功能的变化特点。  方法   收集81例行双肺移植及心肺联合移植受者的临床资料,分析受者术后一般情况。分析肺移植受者术后1个月、3个月、每3个月(术后3~18个月)以及每6个月(术后18~36个月)肺通气及弥散功能指标。分析受者术后的最佳肺功能特点。  结果   受者术后机械通气时间为4(2,9)d,术后重症监护室入住时间为10(7,20)d。81例受者中,27例术后发生原发性移植物功能障碍(PGD),发生率为33%。受者术后用力肺活量(FVC)占预计值百分比(FVC%pred)、第1秒用力呼气容积(FEV1)占预计值百分比(FEV1%pred)、FEV1/FVC占预计值百分比(FEV1/FVC%pred)、校正后肺一氧化碳弥散功能占预计值百分比(DLCOc%pred)随时间发生变化(均为P<0.001)。FVC%pred、FEV1%pred在术后9个月内逐渐上升,DLCOc%pred在术后3个月内逐渐上升(均为P<0.05)。FVC%pred≥80%者36例,FEV1%pred≥80%者41例,FEV1/FVC%pred≥92%者76例;FVC%pred≤40%者1例,FEV1%pred≤40%者1例。DLCOc%pred≥80%者16例,校正后肺一氧化碳弥散功能/肺泡容量占预计值百分比(DLCOc/VA%pred)≥80%者63例;DLCOc%pred≤40%者4例,DLCOc/VA%pred≤40%者1例。原发病为阻塞性肺疾病的受者术后FVC%pred、FEV1/FVC%pred、DLCOc%pred均高于原发病为限制性肺疾病的受者(均为P<0.05)。发生PGD的受者术后DLCOc%pred低于未发生PGD的受者(P<0.05)。  结论   肺移植受者肺通气功能在术后9个月达到最佳状态且达到稳态,肺弥散功能在术后3个月达到稳态,原发病以及是否发生PGD可能对术后肺功能存在影响。

     

  • 图  1  肺移植受者术后肺通气功能动态变化

    Figure  1.  Dynamic changes of postoperative pulmonary ventilation function in lung transplant recipients

    图  2  肺移植受者术后肺弥散功能动态变化

    Figure  2.  Dynamic changes of postoperative pulmonary diffusion function in lung transplant recipients

    图  3  肺移植受者最佳肺通气功能的频数分布

    Figure  3.  Frequency distribution of optimal pulmonary ventilation function in lung transplant recipients

    图  4  肺移植受者最佳肺弥散功能的频数分布

    Figure  4.  Frequency distribution of optimal pulmonary diffusion function in lung transplant recipients

    表  1  阻塞性肺疾病与限制性肺疾病受者最佳肺功能比较

    Table  1.   Comparison of optimal pulmonary function between recipients with obstructive pulmonary disease and restrictive pulmonary disease ($\bar {\boldsymbol{x}} $±s,%)

    肺功能阻塞性肺疾病(n=33)限制性肺疾病(n=48)统计值P
    肺通气功能
     FEV1%pred 85±20 76±21 −1.99 0.04
     FVC%pred 78±16 78±18 −1.07 0.27
     FEV1/FVC%pred 109±11 104±14 −2.18 0.02
    肺弥散功能
     DLCOc%pred 72±18 62±16 −2.67 <0.01
     DLCOc/VA%pred 94±18 92±19 −0.44 0.66
    下载: 导出CSV

    表  2  发生PGD与未发生PGD受者最佳肺功能比较

    Table  2.   Comparison of optimal pulmonary function between recipients with and without PGD ($\bar {\boldsymbol{x}} $±s,%)

    肺功能发生PGD(n=27)未发生PGD(n=54)统计值P
    肺通气功能
     FEV1%pred 75±20 82±22 1.54 0.13
     FVC%pred 72±17 74±19 1.46 0.14
     FEV1/FVC%pred 105±11 107±14 −0.62 0.60
    肺弥散功能
     DLCOc%pred 61±14 69±19 2.00 0.04
     DLCOc/VA%pred 89±15 95±19 1.46 0.14
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-04-25
  • 录用日期:  2023-07-07
  • 网络出版日期:  2023-07-20
  • 刊出日期:  2023-09-15

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