肾移植术后蛋白尿的临床治疗

目的研究肾移植术后蛋白尿的较佳临床治疗方法。方法对90例肾移植术后出现蛋白尿的患者分别采用雷公藤多甙片、火把花根片和环磷酰胺3种不同的药物进行治疗，对其疗效和副作用进行观察，综合分析，判定最佳方案。结果雷公藤多甙片、火把花根片和环磷酰胺均有明显降低肾移植术后尿蛋白的作用，疗效差异无显著性，其中环磷酰胺似乎对重度蛋白尿患者疗效略佳，疗程也短，但是其副作用很大，火把花根片疗效与其他两组差异无显著性，副作用却最小，与其他两组差异有显著性。结论火把花根片在治疗肾移植术后患者蛋白尿方面，略优于雷公藤多甙片和环磷酰胺。     

低浓度环孢素A免疫抑制剂方案应用于肾移植患者的回顾性分析

目的:研究低浓度环孢素A免疫抑制剂方案在肾移植患者中的应用效果.方法:对133名接受肾移植手术的患者进行回顾性分析,根据应用的吗替麦考酚酯(MMF)剂量和环孢素血药浓度不同,将其分为三组:高环孢素浓度-高MMF剂量组、高环孢素浓度-低MMF剂量组和低环孢素浓度-高MMF剂量组. 监测全血环孢素浓度、血肌酐、尿素氮浓度、血脂以及其他并发症的发生情况. 对各组间的差异进行对比分析.结果:应用低环孢素浓度-高MMF剂量免疫抑制剂方案的患者与应用其他方案的患者相比排斥反应的发生率无明显差异,术后感染、代谢异常、药物副作用的发生明显低于其他方案组.结论:应用低环孢素浓度-高MMF剂量免疫抑制剂方案可以有效的预防排斥反应的发生,同时降低了不良反应的发生.     

环孢素与尸体肾移植术后糖尿病

本文报告了肾移植病人术后发生激素性糖尿病。应用环孢素以来，糖皮质激素在肾移植术后应用的剂量与常规免疫抑制剂（硫唑嘌呤＋强的松）比较，其用量已明显减少，但肾移植术后糖尿病的发生率却明显增加。本文就环孢素引起移植术后糖尿病及机理作简要探讨。     

环孢素与尸体肾移植术后糖尿病

本文报告了肾移植病人术后发生激素性糖尿病。应用环孢素以来，糖皮质激素在肾移植术后应用的剂量与常规免疫抑制剂（硫唑嘌呤＋强的松）比较，其用量已明显减少，但肾移植术后糖尿病的发生率却明显增加。本文就环孢素引起移植术后糖尿病及机理作简要探讨。     

肾移植术后两种免疫抑制方案的对比研究

目的 探讨两种免疫抑制方案的疗效和副作用。方法 根据肾移植术后所用免疫抑制方案将121例肾移植分为两组，CMP方案组：环孢霉素A(CsA) 霉酚酸酯(MMH) 泼尼松(Pred)，CAP方案组：CsA 硫唑嘌呤(Aza) Pred，术后观察两组移植。肾功能，排斥反应发生频率及免疫抑制剂的用量和副作用。结果 术后CMP组急性排斥反应发生率低于CAP组，而排斥反应的逆转率却高于CAP组；术后半年内CMP组CsA用量低于CAP组CAP组肝肾中毒，骨髓抑制的发生率明显低于CAP组，两组感染的发生率无明显差异。结论 肾移植术后CMP方案优于CAP方案；MMF在肾移植术后的应用，可以减少肾移植排斥反应的发生，减少药物的副作用，提高肾移植的成功率。     

免疫抑制剂在肾移植术后肺部感染中的应用

目的探讨免疫抑制剂在肾移植术后肺部感染中的应用。方法对12例肾移植术后肺部感染患者采用减少环孢素A（CsA）或他克莫司（FK506）及骁悉（MMF）或咪唑立宾用量，加大皮质醇用量，联合抗细菌、真菌和病毒的综合治疗。结果12例患者中，8例治愈，2例好转，2例最后诊断肺结核给予抗痨治疗。结论恰当调整免疫抑制剂有利于肾移植术后肺部感染的控制，又能避免排斥反应的发生。     

雷公藤片抗肾移植后排斥反应1例

雷公藤片抗肾移植后排斥反应１例广西医科大学附属一院内科（５３００２７）孙安远为了预防排斥反应，肾移植术后常规应用免疫抑制剂。常用的免疫抑制剂有环抱素Ａ、硫唑嘌呤和肾上腺皮质激索等。环孢素Ａ抗排斥反应效果好，但价格昂贵。本文报道１例肾移植术后用价格低廉...     

雷公藤多苷治疗糖尿病肾病临床疗效观察

目的 探讨雷公藤多苷治疗糖尿病肾病的临床疗效及安全性.方法 将笔者所在医院2006年8月～2009年9月住院和门诊治疗的65例DN患者随机分为治疗组(n=33)和对照组(n=32).治疗组在控制饮食、运动、降血糖、降血压、降血脂等常规治疗的基础上接受雷公藤多苷治疗.雷公藤多苷的用量为20 mg,每日3次,3个月后改为10 mg,每日3次,总疗程6个月.观察患者24 h尿蛋白定量、内生肌酐清除率、血清丙氨酸氨基转移酶、血白细胞计数.结果 6个月后,治疗组患者的24 h尿蛋白定量与对照组相比减少更明显,差异有统计学意义(P<0.05);而内生肌酐清除率、血清丙氨酸氨基转移酶、血白细胞计数与对照组相比,差异无统计学意义(P>0.05).结论 在常规治疗的基础上,加用TG联合治疗DN以减少蛋白尿,疗效较好而无不良反应发生.     

肾移植术后肝功能损害86例的护理

1　临床资料　 1994- 11/ 2 0 0 1- 12接受尸体肾移植术患者 34 6例 ,术后有肝功损害 86 (男 6 1,女 2 5 )例 ,年龄 17～ 6 8岁 ,占2 4.8%.术后免疫抑制剂的用法 :1994- 11/ 1998- 11为环孢素+硫唑嘌呤 +强的松三联用药 . 1998- 11以后应用环孢素 +骁悉 +强的松三联用药 .环孢素起始量为 8mg· kg- 1·d- 1 ,骁悉起始量为 1.5～ 2 .0 g· d- 1 .术后 AL T49～ 15 6μ· L- 1 ,总胆红素 19～ 36 2μmol· L- 1 .肾移植术后肝功能损害时 ,停止或减少环孢素、硫唑嘌呤用量 ,改用其他免疫抑制剂 ,如普乐可复、骁悉等 .肝炎型应用保肝药物 (肝…     

雷公藤多苷片治疗临床蛋白尿期糖尿病肾病的疗效观察

目的:观察雷公藤多苷片治疗临床蛋白尿期糖尿病肾病的有效性与安全性。方法:将92例临床蛋白尿期糖尿病住院患者随机分为试验组和对照组,对照组给予常规降血糖药物治疗,试验组在常规治疗的基础上给予雷公藤多苷片。用药10周后,比较两组患者治疗前后临床症状、尿蛋白(UAlb)、血清白蛋白、血尿素氮(BUN)、血肌酐(Scr)以及体液免疫指标的变化情况。结果:口服雷公藤多苷片治疗的患者临床症状有显著的改善(P<0.05);尿蛋白减少的作用较对照组更为明显,且差异具有统计学意义(P<0.01),但两组患者在治疗前后的BUN和Scr水平无明显改变(P>0.05);血清白蛋白、IgG、IgA、C3、C4水平明显变化;试验组和对照组在治疗期间均未见明显不良反应。结论:雷公藤多苷片可有效改善临床蛋白尿期糖尿病肾病的临床症状,并且大大降低患者的尿蛋白,增强体内免疫抗体,从根本上改善患者的病情,疗效显著,且安全可靠,值得向临床推荐。     

肾移植术后单剂应用人源化抗CD3单克隆抗体的临床观察

目的 研究肾移植受者体内应用人源化抗CD3单克隆抗体(OKT3)注射液单次剂量递增给药后的短期和长期安全性.方法 2008年6-12月,共29例肾功能稳定的尸体肾移植受者入选该研究.每位受试者按入组顺序随机分至2.5 mg(n=9)、5.0 mg(n=10)、10.0 mg(n=10)3个剂量组,并于移植术后7～14 d内接受相应剂量的OKT3单次给药.同时选取同期未参加试验的30例肾移植受者作为对照组.所有患者至少随访2年,随访期间监测肝功能、肾功能、血常规等指标,并观察有无其他不良事件.结果 各剂量组受试者在给药后48 h内,出现低热(7/29)、畏寒(4/29)、肝功能损害(2/29)、上呼吸道感染(1/29)和头痛(1/29),未出现明显的首剂效应,其余的不良反应轻微,发生率与剂量无关.随访期间内,试验组和对照组2-年人/肾长期存活率分别为100%/100%和100%/97%;移植肾活检证实的急性排斥发生率分别为6.9%(2/29)和10.0%(3/30),肺部感染发生率分别为10.3%(3/29)和13.3%(4/30).术后1周及3、6、12、24个月监测血肌酐值显示,两组差异均无统计学意义(均P＞0.05).结论 人源化OKT3不同剂量单次给药在肾移植受者体内安全性良好,其有望成为一种抗排斥能力强、毒副作用较小的免疫抑制剂.

Abstract：

Objective To evaluate short-term and long-term safety of using single-dose escalation of recombinant humanized anti-CD3 monoclonal antibody (OKT3) in kidney transplantation recipients.Methods A total of 29 recipients of cadaveric kidney transplant from June 2008 to December 2008 were sequently assigned to receive single-dose intravenous injection of OKT3 with different doses of 2. 5 mg( n =9) , 5.0 mg (n = 10) and 10. 0 mg (n = 10) at Days 7 - 14 post-operation. Meanwhile, a control group was established by selecting kidney transplant recipients, who did not participate in the trial in the same period.All patients were followed up for at least 2 years. During this period, liver function, kidney function,hemoglobin and other biochemical indicators were monitored and adverse events recorded over time. Results No obvious first dose effect was observed,except low heat (7/29), chills (4/29) , mild liver damage (2/29) , upper respiratory tract infection and headache (1/29) across all doses. Other adverse reactions were mild, unrelated with doses. The 2-year patients/ grafts survival rates of treatment goup and control group were 100% / 100%, and 100% / 97%, respectively. The incidence of acute rejection confirmed by renal biopsy was 6. 9% (2/29) and 10. 0% (3/30) in treatment group and control group, respectively. The incidence of lung infection was 10. 3% ( 3/29 ) and 13.3% ( 4/30 ), respectively. The values of serum creatinine at 1 week and 3, 6, 12, 24 months showed no statistically significance in two groups ( all P ＞0. 05). Conclusion It is safe to use single-shot OKT3 intravenously in kidney transplant recipients. The recombinant humanized OKT3 may be an effective immunosuppressive agent with milder toxicity for solid organ transplantation.     

他克莫司缓释剂治疗儿童原发性肾病综合征的药代动力学特点

目的 他克莫司是一种新型钙调磷酸酶抑制剂,目前被广泛应用于成人肝或肾移植术后,也被逐渐广泛应用于肾病综合征患儿。他克莫司缓释胶囊是每日单次口服的缓释剂型,本研究目的是初步探讨他克莫司缓释剂治疗儿童原发性肾病综合征的药代动力学特征。方法 8例受试者系北京大学第一医院2011年6—8月原发性肾病综合征患儿。晨起单次口服不同剂量他克莫司缓释胶囊,给药剂量分别为0.02 mg/kg(n=2)、0.05 mg/kg(n=2)、0.10 mg/kg(n=4),在服药前及服药后1、2、4、6、8、10、12 h分别取静脉血1~2 mL,受试者不用影响他克莫司浓度的其他药物、食物及饮料。采用酶放大免疫分析法,测定他克莫司血药浓度,以Phoenix计算其药代动力学参数。结果 药代动力学数据采用非房室模型分析。3个剂量组(0.02 mg/kg,0.05 mg/kg和0.10 mg/kg)药代动力学参数如下:血药峰浓度分别为(1.7±1.0) μg/L,(3.1±1.9) μg/L,(8.0±3.5) μg/L;药物浓度-时间曲线下面积分别为(47.2±47.1) h·μg/L,(84.0±13.1) h·μg/L,(175.6±107.1) h·μg/L;表观清除率分别为(0.8±0.9) L/(h·kg),(0.4±0.1) L/(h·kg),(1.9±1.3) L/(h·kg);经剂量归一化的表观分布容积分别为(7.0±3.4) L/kg,(12.4±8.4) L/kg,(73.6±68.6) L/kg。0.05 mg/kg剂量组经剂量归一化的血药峰浓度和经剂量归一化的药物浓度-时间曲线下面积的平均值均高于0.02 mg/kg及0.10 mg/kg剂量组。3个剂量组的药物浓度-时间曲线均呈现2次高峰,第一次高峰出现在服药后约2 h,服药后约12 h出现次级高峰;0.10 mg/kg剂量组药物浓度出现两次峰值的现象较0.02 mg/kg及0.05 mg/kg剂量组更显著。结论 他克莫司缓释剂治疗原发性肾病综合征患儿的药代动力学存在个体间差异,本研究初步探讨了他克莫司缓释剂治疗儿童原发性肾病综合征的药代动力学特征,为后续大样本的研究提供了参考依据。     

Alemtuzumab induction therapy in highly sensitized kidney transplant recipients

Background  Immunosuppression for immunologically high-risk kidney transplant patients usually involves antithymocyte globulin induction with triple drug maintenance therapy. Alemtuzumab, a humanized anti-CD52 antibody, was expected to be a promising induction therapy agent for kidney transplantation. However, currently no consensus is available about its efficacy and safety. This study aimed to evaluate the efficacy and safety of alemtuzumab as immune induction therapy in highly sensitized kidney transplant recipients.

Methods  In this prospective, open-label, randomized, controlled trial, we enrolled 23 highly immunological risk patients (panel reactive antibody >20%). They were divided into two groups: alemtuzumab group (trial group) and anti-thymocyte globulin (ATG) group (control group). Patients in the alemtuzumab group received intravenous alemtuzumab (15 mg) as a single dose before reperfusion. At the 24th hour post-operation, another dosage of alemtuzumab (15 mg) was given. The control group received a bolus of rabbit ATG (9 mg/kg), which was given 2 hours before kidney transplantation and lasted until the removal of vascular clamps when the anastomoses were completed. Maintenance immunosuppression in both groups comprised standard triple therapy consisting of tacrolimus, prednisone, and mycophenolate mofetil (MMF). Acute rejection (AR) and infection episodes were recorded, and kidney function was monitored during a 2-year follow-up. χ² test, t test and Kaplan-Meier analysis were performed with SPSS17.0 software.

Results  Median follow-up was 338 days. In both the alemtuzumab group and ATG group, creatinine and blood urea nitrogen values in surviving recipients were similar (P >0.05). White blood cell counts were significantly reduced in the alemtuzumab group for the most time points up to 6 months (P <0.05). One patient receiving alemtuzumab died for acute myocardial infarction at the 65th day post-operation. Two ATG patients died for severe pulmonary infection or cardiac and pulmonary failure. Cumulative 2-year graft survival rate was 90.9% in the alemtuzumab group and 81.8% in ATG group (P >0.05) respectively. There was one graft failure in the alemtuzumab group and two graft failures in ATG group, with all graft failures at tributed to rejection episodes. The alemtuzumab group had a 2-year cumulative freedom from rejection rate of 81.8%, compared with 72.7% for the ATG group (P >0.05).

Conclusion  Alemtuzumab induction therapy for highly sensitized kidney transplant recipients is an effective and safe protocol yielding an acceptable acute rejection rate.

     

肾移植术后受者体质量指数对其死亡的影响分析

【目的】探究肾移植术后受者体质量指数对其死亡的影响。【方法】回顾分析本院2001～2010年死亡的207例肾移植受者资料。根据受者术后随访期间的身体质量指数（BM I ）将其分为偏瘦组（BM I＜18．5 kg/m2,n ＝55）、正常组（18．5 kg/m2≤BMI＜24k g/m2,n＝100）和超重组（BMI≥24 kg/m2,n＝52）,对三组受者死亡原因、受者存活率和移植肾存活率进行比较分析。【结果】所有受者的前三位死亡原因依次为感染（31．9％）、心血管疾病（21．3％）和肝功能衰竭（15．9％）;超重组中移植肾失功能死亡和因心血管疾病死亡的比率均明显高于偏瘦组和正常组（P＜0．05）;正常组肾移植术后受者存活率明显高于偏瘦组和超重组（P ＜0．05）;正常组术后3年、5年受者存活率明显高于偏瘦组和超重组（P＜0．05）,但1年、10年受者存活率三组比较无统计学差异（P＞0．05）;正常组肾移植术后移植肾存活率明显高于偏瘦组和超重组（ P＜0．05）。【结论】肾移植术后受者BM I≥24 kg/m2是增加心血管疾病死亡和降低受者及移植肾存活率的一个风险因素。     

肾移植受者疾病不确定感现状及其与应对方式的相关性研究

  目的   探讨肾移植受者疾病不确定感现状,分析疾病不确定感与应对方式的相关性,为进一步研究提供参考。   方法   采用方便抽样法,选取肾移植受者259例为研究对象,使用一般资料调查表、疾病不确定感量表(MUIS)、医学应对方式问卷(MCMQ)对研究对象进行调查。   结果   肾移植受者疾病不确定感的得分为(87.86±12.67)分,其中4个维度平均得分由高到低分别为不明确性维度(37.88±8.13)分,信息缺乏维度(19.34±4.69)分,复杂性维度(16.00±3.22)分,不可预测性维度(14.63±2.62)分;肾移植受者更倾向选择面对的应对方式(64.1%),3种应对方式的平均得分分别为面对(19.98±3.81)分、回避(14.44±2.97)分、屈服(8.81±3.17)分,疾病不确定感总分、不明确性维度、复杂性维度和信息缺乏维度得分与应对方式中的屈服方式呈正相关关系(r=0.320、0.297、0.131、0.249,均P < 0.05),未发现不可预测性维度与应对方式之间的相关关系。   结论   肾移植受者的疾病不确定感处于中水平。医务人员应当注重肾移植受者疾病不确定感的评价与管理及其与应对方式的相关性,引导肾移植受者采用积极的方式应对,降低其疾病不确定感。      

The first 10 years of the dialysis-transplantation program at The Hospital for Sick Children, Toronto. 2. Transplantation and complications of chronic renal failure.

Between January 1969 and August 1977, 78 children received 100 kidney transplants (94 from cadavers and 6 from living donors) at The Hospital for Sick Children, Toronto. Since 1971 the average wait for a first cadaveric transplant has been less than 5 months. Preferably the kidney is placed in a location that has not previously undergone an operation, usually the iliac fossa on the side opposite that from which the donor kidney was taken. Immunosuppressive therapy begins with prednisone (or methylprednisolone), 3 mg/kg body weight per day; the dose is gradually decreased until a maintenance dose of 10 to 20 mg every 48 hours is reached 3 to 6 months postoperatively. Azathioprine, 2 to 3 mg/kg body weight, is also given each day. Early recognition or prevention of renal osteodystrophy, the toxic effects of steroids, psychosocial problems, growth retardation and hypertension minimize their effects on these patients.     

The effect of CYP3A5 polymorphisms on the pharmacokinetics of tacrolimus in adolescent kidney transplant recipients.

BACKGROUND: CYP3A5 gene polymorphism has been shown to influence tacrolimus (TAC) blood concentration and dose requirement in adult kidney transplant patients. The aim was to analyze retrospectively the modification induced by CYP3A5 gene polymorphism on TAC's pharmacokinetic parameters obtained from 26 adolescents receiving TAC as their main immunosuppressive drug. MATERIAL/METHODS: The adolescent kidney transplant patients were genotyped for CYP3A5*3 and grouped accordingly. TAC dose, blood levels, and dose-normalized TAC blood concentration and volume of distribution obtained at different post-transplant periods during the first post-transplant year were correlated with the corresponding genotype. RESULTS: During the first three months post-transplant, heterozygotes (CYP3A5*1/*3) displayed a lower TAC blood concentration than homozygotes (CYP3A5*3/*3) (at 1 month: 7.8+/-2.1 vs. 13.4+/-6 ng/ml, p=0.007) despite a therapeutic monitoring strategy. Between 3-12 months post-transplant, TAC blood concentration was comparable between the two groups, but a two-fold increase in the daily drug dose was necessary for the heterozygotes (at 6 months: 0.23+/-0.1 vs. 0.13+/-0.06 mg/kg, p=0.04). The dose-normalized TAC concentration [(ng/ml)/(mg/kg)] was significantly lower in patients displaying the CYP3A5*1/*3 polymorphism (at 2 weeks: 33+/-2.16 vs. 71.1+/-37.8, p=0.01; 6 months: 35.4+/-12.9 vs. 85.2+/-58.9, p=0.01). At the same time, the volume of distribution of the drug in the latter group was distinctly increased for the entire post-transplant year (at 6 months: 1.79+/-0.42 vs. 0.73+/-0.5 l/kg, p=0.001). CONCLUSIONS: The great influence of CYP3A5 on the pharmacokinetics and pharmacodynamics of TAC in young transplant recipients suggests the need for pre-transplant screening of this polymorphism to improve TAC therapy.     

Autosomal dominant polycystic kidney disease is not a risk factor for post-transplant diabetes mellitus. Matched-pair design multicenter study

BACKGROUND: Post-transplant diabetes mellitus (PTDM) is a relatively common complication of kidney transplantation. The aim of our work was to compare the incidence of PTDM in kidney transplant recipients with and without autosomal dominant polycystic kidney disease (ADPKD) in a matched-pair design study. METHODS: In total, 98 pairs of graft recipients, all of Caucasian origin and who received a kidney from the same cadaveric donor, were included in the study. The following clinical data were collected for statistical analysis: age, body mass index (BMI) before transplant, length and type of dialysis treatment, residual diuresis, and cold and warm graft ischemia time. Diabetes was diagnosed based on American Diabetes Association (ADA) criteria. RESULTS: Incidence of PTDM was 19.4% in the ADPKD group and 18.4% in the non-ADPKD group, with no significant differences between groups. Multivariate logistic regression analysis of the PTDM risk in the ADPKD group including age, gender, BMI, and dialysis time as independent variables indicated that only higher residual diuresis is a significant independent risk factor (OR = 5.64 per every L/24 h, 95% CI = 1.31-24.33, p = 0.017). Similarly, logistic regression analysis adjusted for age and gender in the non-ADPKD group has shown that significant independent risk factors are BMI (OR = 1.30 per every kg/m(2), 95% CI = 1.06-1.59, p = 0.0094), longer dialysis time prior to transplant (OR = 1.036 per each month, 95% CI = 1.004-1.070, p = 0.025), and a history of arterial hypertension (OR = 9.09, 95% CI = 1.20-68.66, p = 0.030). CONCLUSIONS: In this paired analysis, our results suggest that diagnosis of ADPKD does not increase risk of PTDM.     

Ganciclovir treatment of cytomegalovirus disease in transplant recipients and other immunocompromised hosts

Thirty-one immunocompromised patients with severe cytomegalovirus (CMV) disease were treated with intravenous ganciclovir. Twenty-one patients had received transplants--15 bone marrow recipients, five renal allograft recipients, and one liver transplant recipient--while the other ten were immunocompromised due to acquired immunodeficiency syndrome (six), hematologic malignancies (three), and systemic lupus erythematosus (one). They presented with one or more of the following syndromes: CMV pneumonitis (19), CMV of the gastrointestinal tract (six), CMV retinitis (seven), and CMV hepatitis (three). Seventeen (55%) of 31 patients demonstrated clinical improvement during ganciclovir therapy, with the best response seen in the transplant recipients. Viremia ceased in 14 (93.3%) of 15 patients after a mean of 4.7 days of therapy; viruria ceased in eight (53.3%) of 15 patients after a mean of 11 days of therapy. Ganciclovir plasma concentrations at a dosage of 2.5 mg/kg/three times a day were as follows: mean peak, 16.04 mumol/L; mean trough, 2.38 mumol/L. Neutropenia occurred in 11 (35%) of 31 patients and in nine (60%) of 15 bone marrow transplant recipients. We conclude that ganciclovir exerted an antiviral effect against CMV and may play a role in the treatment of CMV disease in patients with depressed immunity, especially bone marrow and organ transplant recipients.     

肾移植受者衰弱与睡眠质量相关性研究

  目的  探究肾移植受者衰弱与睡眠质量的相关性，为临床预防和干预肾移植受者衰弱提供借鉴。  方法  纳入2019年6—10月北京市首都医科大学附属北京朝阳医院就诊的200例肾移植受者进行问卷调查，睡眠质量采用匹兹堡睡眠质量量表(PSQI)测量，衰弱情况使用Tilburg衰弱指数量表测量。采用非参数检验比较衰弱与非衰弱肾移植受者的睡眠特点，运用spearman相关分析的方法分析肾移植受者睡眠质量与衰弱的相关关系。  结果  肾移植受者衰弱发生率为41%，衰弱总得分中位数为3(2, 6)分，以躯体衰弱得分最高。20%的肾移植受者睡眠质量较差，最常见的睡眠问题为日间功能障碍、入睡时间延长以及主观睡眠质量差，分别占总人数的39.50%、35.50%和22.50%。与衰弱肾移植受者相比，非衰弱受者睡眠质量显著较好(Z=-5.745，P＜0.001)。肾移植受者的衰弱评分与睡眠质量评分相关，相关系数r=0.452(P＜0.001)，躯体衰弱和心理衰弱与多种睡眠问题有关。在PSQI各成分中，日间功能障碍与衰弱程度相关性最高(r=0.491，P＜0.001)。  结论  肾移植受者衰弱发生率较高，存在多种睡眠问题，大部分受者睡眠时间充足，衰弱发生可能与夜间睡眠质量差有关，睡眠质量越差的受者其衰弱程度可能越重，提示应关注肾移植受者夜间睡眠质量，及时识别睡眠障碍，对出现作息时间紊乱、夜间觉醒频繁、睡眠呼吸障碍等问题的受者，采取适当的干预措施帮助受者提高睡眠质量。