多囊肾患者肾移植的临床研究

目的　分析多囊肾病 (PKD)患者肾移植术后移植效果 ,并探讨影响因素。方法　选取19 78年至 2 0 0 2年 46例PKD肾移植患者 (PKD组 )和 46例其它肾脏病 (非糖尿病肾病 )肾移植患者(对照组 )进行回顾性分析。评估人、肾存活率 (肾移植后 1、3和 5年 ) ,以及术后并发症 ,如感染和心血管疾病等情况。结果　两组患者 1、3、5年人存活率 :PKD组为 95.7%、91.3 %、91.3 % ;对照组为97.8%、95.7%、93 .5% ;肾存活率 :PKD组为 93 .5%、89.1%、87.0 % ;对照组为 95.7%、89.1%、87.0 %。PKD组中 ,女性患者 5年移植人、肾存活率达到 10 0 %、10 0 % ,男性只有 88.2 %、82 .4% ,差异有显著性 (P <0 .0 5)。PKD组患者比对照组更易发生尿路感染 (P <0 .0 5) ;其它部位的感染发生率相似。两组心血管并发症差异无显著性 (PKD组 3例 ,对照组 4例 )。结论　PKD组和对照组总的人、肾存活率差异无显著性。PKD组的女性患者肾移植后存活率高于男性 ,可能与性激素的影响有关。尿路感染和严重的肺部感染可能是PKD患者术后主要的并发症。

Clinical study on renal transplantation in polycystic kidney disease

ObjectiveTo study the outcome of renal transplantation in polycystic kidney disease (PKD) and its influencing factors.MethodsFrom 1978 to 2002, 46 PKD patients undergoing renal transplantation (PKD group) and 46 cases of other diseases (non-diabetic nephropathy;control group) were retrospectively analyzed. Patient/renal survival rate (1, 3 and 5 years after re nal transplantation) and postoperative complications were evaluated.ResultsA comparable overall patient (1, 3 and 5 years: 95.7?% , 91.3?% , 91.3 ?% PKD vs 97.8?% , 95.7?% , 93.5?% controls) and transplant sur vival rate (1, 3 and 5 years: 93.5?% , 89.1?% , 87.0?% PKD vs 95 .7?% , 89.1?% , 87.0?% controls) was found in both groups. Infectious complications with the exception of urinary tract infections (UTIs: PKD 43.4 ?% vs 10.9?% ) were diagnosed in similar frequency in the graft recipien ts. PKD patients were significantly more affected by UTIs than the control group (P< 0.05 ).Cardiovascular events were not observed to be significantly d ifferent between the two groups (PKD 3 vs controls 4). An obvious difference wa s found in patients (P< 0.05 ) and transplant survival rates (P< 0.05 ) of male and female PKD patients. The female group showed a significantly bet ter outcome.ConclusionsThe overall patient and graft survival rates did not differ between the PKD and control groups. The better outcome of female PKD graft recipients compared to th e male group may be related to a gender-dependent disease severity, possibly du e to hormonal effects. UTIs and lethal lung infections were the leading complica tions after transplantation in PKD patients.