南方医科大学学报2018，Vol.38Issue(2)：155-161,7.DOI:10.3969/j.issn.1673-4254.2018.02.06
移植肾动脉狭窄的临床危险因素和保护因素
A high level of high-density lipoprotein cholesterol is a protective factor against transplant renal artery stenosis
摘要
Abstract
Objective To investigate the factors associated with the occurrence of transplant renal artery stenosis (TRAS). Methods A retrospective analysis was conducted in 26 recipients who developed TRAS and 40 concurrent renal recipients without TRAS. We also conducted a nested case-control study in 14 patients with TRAS (TRAS-SD group) and another 14 non-TRAS recipients who received the allograft from the same donor (non-TRAS-SD group). Results Compared with those in the concurrent recipients without TRAS, acute rejection (AR) occurred at a significantly higher incidence (P=0.004) and the warm ischemia time (WIT) was significantly longer (P=0.015) and the level of high-density lipoprotein cholesterol (HDL-C) significantly lower (P=0.009) in the recipients with TRAS. Logistic regression analysis suggested that AR (P=0.007) and prolonged WIT (P=0.046) were risk factors of TRAS while HDL-C (P=0.022) was the protective factor against TRAS. In recent years early diagnosis of TRAS had been made in increasing cases, the interval from transplantation to TRAS diagnosis became shortened steadily, and the recipients tended to have higher estimated glomerular filtration rate at the time of TRAS diagnosis. Conclusion Apart from the surgical technique, AR and prolonged WIT are also risk factors of TRAS while a high HDL-C level is the protective factor against TRAS. The improvement of the diagnostic accuracy by ultrasound is the primary factor contributing to the increased rate of early TRAS diagnosis in recent years.关键词
移植肾动脉狭窄/急性排斥反应/热缺血时间/高密度脂蛋白胆固醇Key words
Transplant renal artery stenosis/acute rejection/warm ischemia time/high-density lipoprotein cholesterol引用本文复制引用
刘燕娜,于立新,邓文锋,李凯群,刘如敏,叶桂荣,符芳翔,李江涛,苗芸..移植肾动脉狭窄的临床危险因素和保护因素[J].南方医科大学学报,2018,38(2):155-161,7.基金项目
国家自然科学基金(81500573) （81500573）
广东省高等教育学会高等教育科学研究"十三五"规划重点调研课题(16GZD009) （16GZD009）
南方医科大学南方医院院级教育课题(14NJ-ZL01) （14NJ-ZL01）
南方医科大学大学生创新创业训练项目基金(201612121006) Supported by National Natural Science Foundation of China (81500573). （201612121006）
