摘要
目的:分析美国肺源分配评分(LAS)在我国肺移植受者中应用的意义。方法:回顾性分析2005年5月至2018年3月接受肺移植受者的临床资料,采用美国器官获取和移植网络(OPTN)的LAS计算器计算受者的LAS分值,并进行分组分析。结果:共纳入173例受者,年龄(56.49±12.64)岁(19~81岁),LAS分值(56.63±18.39)分(32.79~90.70分)。按疾病类型分类:慢性阻塞性肺疾病(COPD)62例,间质性肺疾病85例,支气管扩张症11例,肺动脉高压8例,其他7例,上述疾病受者LAS分值分别为(47.85±15.22)、(61.89±18.63)、(56.58±18.91)、(55.23±10.74)和(72.45±16.41)分,COPD组受者LAS明显低于间质性肺疾病受者(P<0.001)。按术前疾病严重程度分组:重症组(气管插管或ECMO支持)57例,LAS(79.15±7.95)分;无创通气组39例,LAS(48.42±11.58)分;吸氧组77例,LAS(44.11±8.81)分,差异有统计学意义(P<0.001)。按LAS分值分组:LAS<50为低危组,50~75为中危组,>75为高危组,三组受者术后3个月存活率分别为90.5%、81.8%和71.1%;1年存活率分别为85.4%、74.4%和57.8%,差异有统计学意义(P=0.002)。结论:LAS可反映受者等待肺移植的紧迫性,而且与术后早期存活率相关;临床上可采用LAS选择合适受者,理想的肺移植受者LAS为30~75分。
Objective To explore the significance of US lung allocation score(LAS)in Chinese lung transplant recipients.Methods The clinical data were analyzed for 173 lung recipients from May 2005 to March 2018.The LAS of each patient was calculated by an online LAS calculator of Organ Procurement and Transplantation Network(OPTN).Results The mean age was(56.49±12.64)years and the mean LAS(56.63±18.39)(32.79-90.70).The underlying diseases were chronic obstructive pulmonary disease(COPD,n=62),interstitial lung disease(n=85),bronchiectasis(n=11),pulmonary arterial hypertension(n=8)and others(n=7).And the value of LAS was(47.85±15.22)vs.(61.89±18.63)vs.(56.58±18.91)vs.(55.23±10.74)vs.(72.45±16.41).LAS of COPD patients was significantly lower than that of interstitial lung disease(P<0.001).Mean LAS was the highest in endotracheal intubation or ECMO group(79.15±7.95),then non-invasive ventilation group(48.42±11.58)and lowest in oxygen inhalation group(44.11±8.81)(P<0.001).Recipients were divided into three groups of LAS<50 for low-risk,50-75 for moderate-risk and>75 for high-risk.Survivals at 90 days and 1 year were 90.5%vs.81.8%vs.71.1%and 85.4%vs.74.4%vs.57.8%(P=0.002).Conclusions LAS can not only reflect the urgency of recipients waiting for lung transplantation but also predict postoperative period.LAS score should be employed for selecting suitable lung transplant recipients in China and the optimal LAS lies between 30 and 75.
作者
练巧燕
陈奥
彭桂林
徐鑫
韦兵
黄丹霞
何建行
巨春蓉
Lian Qiaoyan;Chen Ao;Peng Guilin;Xu Xin;Wei Bing;Huang Danxia;He Jianxing;Ju Chunrong(State Key Lab of Respiratory Disease,Guangzhou Institute of Respiratory Health,First Affiliated Hospital,Guangzhou Medical University,Guangzhou 510120,China)
出处
《中华器官移植杂志》
CAS
北大核心
2020年第2期99-102,共4页
Chinese Journal of Organ Transplantation
基金
呼吸疾病国家重点实验室青年自主课题(SKLRD-QN-201710)
广东省自然科学基金-自由申请(2018A030313107)
2019年度广州呼吸健康研究院/广医一院临床研究中心临床自主探索项目(2019GIRHZ04)。
关键词
肺移植
肺源分配评分
预后
Lung transplantation
Lung allocation score
Prognosis
