摘要
背景：肾移植后早期约有2／3以上患者伴有高脂血症，其是慢性移植肾病以及移植后肾失功的重要危险因素。目的：分析肾移植后早期患者血清脂质紊乱的特点。设计、时间及地点：病例-对照观察，于2004-05／2006-05在郑州大学第一附属医院完成。对象：选择肾移植后患者84例，另外选择同期门诊健康体检者49例作为对照。方法：84例肾移植患者根据志愿原则和经济条件选择不同免疫抑制剂治疗方案。环孢素A组53例，他克莫司组31例。根据环孢素A组患者服药期间平均环孢素A峰浓度分组，将环孢素A峰浓度≥852．611μg/L设定为高环孢素A峰浓度组（n=22），〈852．61μg/L为低环孢素A峰浓度组（n=31）。主要观察指标：分别于肾移植前和移植后3，6，12个月检测患者各项血清脂质指标水平，并与同期健康体检者进行对比。结果：①肾移植组移植后多数时间血清总胆固醇、三酰甘油和低密度脂蛋白胆固醇指标明显高于移植前和对照组（P〈0．05-0．01），高密度脂蛋白胆固醇则明显低于移植前和对照组（P〈0．05—0．01）。②环孢素A组移植后大部分时间血清总胆固醇、三酰甘油和低密度脂蛋白胆固醇水平均明显高于移植前和他克莫司组（P〈0．05～0．01），高密度脂蛋白胆固醇则明显低于移植前和他克莫司组（P〈0．05～0．01）。③高环孢素A峰浓度组移植后大部分时间血清总胆固醇、三酰甘油和低密度脂蛋白胆固醇水平均明显商于移植前和低环孢素A峰浓度组（P〈0．05～0．01），高密度脂蛋白胆固醇则明显低于移植前和低环孢素A峰浓度组（P均〈0．05-0．01）。结论：肾移植后早期患者存在着明确的血清脂质紊乱．与使用环孢素A类免疫抑制药物及其血药峰浓度密切相关。
BACKGROUND： About 2/3 of renal transplant recipients are accompanied with hyperlipemia, which is an important risk factor of chronic transplant nephropathy and renal dysfunction after transplantation. OBJECTIVE： To analyze patients＇ characteristics of early stage disorder of serum lipid after transplant. DESIGN, TIME AND SETTING： A case-controlled observation was performed in the First Affiliated Hospital of Zhengzhou University from May 2004 to May 2006. PARTICIPANTS： Totally 84 renal transplant recipients and 49 health examinees were recruited in this study. METHODS： According to the patient＇s will and economics condition, 53 of 84 cases were treated with ciclosporin A, including high concentration group （n=22） of ≥852.61 μ g/L and low concentration group （n=31） of 〈 852.61 μ g/L, while other 31 of 84 cases were treated with tacrolimus. MAIN OUTCOME MEASURES： The serum lipids in 84 renal transplant recipients were determined before transplantation and 3, 6 and 12 months after transplantation, and compared with persons receiving health examination in the corresponding period. RESULTS： The levels of triacylglycerol （TG）, total cholesterol （TC） and low density lipoprotein cholesterol （LDL-C） in renal transplant recipients after transplantation were clearly higher than before transplantation and in the control group （P 〈 0.05-0.01）. High density lipoprotein cholesterol （HDL-C） levels were clearly lower than before transplantation and in the control group （P 〈 0.05-0.01）. Most of detection values ofTG, TC and LDL-C in the ciclosporin A group after transplantation were clearly higher than before transplantation and that in the tacrolimus group （P 〈 0.05-0.01）. HDL-C values were clearly lower than before transplantation and that in the tacrolimus group （P 〈 0.05-0.01）. Most of detection values of TG, TC and LDL-C in the high peak concentrations of ciclosporin A group after transplantation were clearly higher than before transplantation and that in the low peak concentrations group （P 〈 0.05-0.01）. HDL-C values were clearly lower than before transplantation and that in the low peak concentrations group （P 〈 0.05-0.01）. CONCLUSION： Renal transplant recipients have obvious early stage disorder of serum lipid. The disorder is closely related to the use of ciclosporin A immunosuppressants and blood concentration of ciclosporin A.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2008年第40期7829-7832,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
