腰椎棘突及其间隙的解剖学测量*

目的利用三维重建技术为棘突间撑开的设计、优化、国产化及临床应用提供解剖学依据。方法选取50例志愿者采用连续螺旋CT断层扫描T12~S1,将获得图像导Materialise Mimics10.01软件,采取轮廓和区域增长分割出腰椎骨组织,采用表面遮盖显示法进行三维表面重建,选择去除椎旁组织的最佳三维角度,由同一名研究者选择适合测量的图像进行测量,测量棘突厚度、棘突长度、棘突间距。各解剖结构连续测量3次,取其均值。数据进行正态性检验、检验。结果①棘突厚度:一般每个腰椎的棘突厚度均前部>后部>中部,下缘>中央>上缘。但L5较特殊,棘突中部和后部的中央厚,上、下缘薄。相邻上位腰椎棘突下缘厚度大于下位腰椎棘突上缘厚度。②棘突长度以L3最大,男性:上缘26.62±2.98mm,中央25.59±2.33mm,下缘22.73±2.40mm;女性:上缘23.76±2.47mm,中央24.49±2.48mm,下缘19.70±2.49mm;男女均以L5最小。③棘突间距:男性以L2∕3最大,向下依次减小,前部>中部>后部。前部10.39±2.70mm,中部11.15±2.20mm,后部9.35±2.17 mm。女性以L1∕2最大,向下依次减小,前部>中部>后部。前部10.32±2.10mm,中部12.18±2.58mm,后部10.80±2.43mm。男女均以L4∕5最小。结论棘突间距从上向下逐渐减小,前部>中部>后部,在矢状面棘突间隙呈前高后矮的楔形。棘突长度以L3最大,L5最小。棘突长度均上缘>中央>下缘,相邻上位腰椎棘突下缘长度<下位腰椎棘突上缘长度。棘突厚度前部>后部>中部,且下缘>中央>上缘。相邻上位腰椎棘突下缘厚度>下位腰椎棘突上缘厚度。本研究利用三维CT重建技术初步获得了国人腰椎棘突及棘突间隙的解剖学参数,为适合国人特点的腰椎棘突间撑开器的设计和临床应用提供了解剖学数据。     

CTU和CTA在经皮肾镜手术临床带教中的应用

<正>经皮肾镜手术是通过经皮肾盂通道对肾和输尿管上段结石进行治疗的关键技术,也是泌尿外科腔内手术临床带教的重点和难点[1]。对肾盏、肾盂、肾和肾周组织、器官解剖结构的精细了解,是指导下级医师和进修医师完成经皮肾盂通道建立、提高清石效率和预防手术并发症的重要基础。CTU(CT尿路成像)和CTA(CT肾血管成像)能提供肾结石、肾盏、肾盂、肾脏、肾血管和肾周组织、器官三维解剖图像,这使得CTU和CTA在经皮     

单侧重复肾、输尿管畸形一例

患者男性，34岁，亲属捐肾前行肾动脉造影术，造影显示：右肾脏未见异常；左肾体积明显大于对侧，左侧显示两个肾脏、输尿管；左肾动脉未见异常。第二日行静脉肾盂输尿管造影检查：右侧肾盂、肾盏未见异常，左侧完全重复肾、输尿管畸形；左侧上位肾具有肾小盏、肾大盏结构，下位肾具有正常肾脏肾小盏、肾大盏、肾盂结构，双侧输尿管内外分布，均开口于膀胱三角区附近。见图。     

改良构建大鼠单侧输尿管梗阻肾间质纤维化模型

文题释义：肾盂积液：输尿管完全或不完全梗阻时,由于尿液无法正常排出体外而导致肾盂积液。慢性肾盂积液引起的肾脏损伤是不可逆的,可由多种上尿路梗阻性疾病诱发,导致肾盂肾盏扩大,肾小管与肾小球结构与功能丧失,进而肾组织萎缩。 肾间质纤维化：是各种慢性肾病发展至终末期的共同病理特征,以肾小管间质瘢痕硬化为特征,最终导致肾脏组织功能完全丧失。该过程受到转化生长因子β、成纤维细胞生长因子、内分泌等信号通路的调控,肾间质纤维化动物模型是研究相关药物药理机制的重要模型。 背景：传统的大鼠单侧输尿管梗阻手术方法,可以在较短的时间内(一两周)导致动物梗阻侧肾脏发生肾间质纤维化,但具有术后并发症较多、死亡率较高的缺点。 目的：优化并改良大鼠单侧输尿管梗阻手术操作,降低动物术后的并发症发生率,提高存活率,检测改良单侧输尿管梗阻方法建模大鼠的病理生理指标,为功能药理学基础研究提供背景数据支持。 方法：①取20只雄性SD大鼠,随机分为4组,分别进行传统单侧输尿管梗阻方法结扎、改良单侧输尿管梗阻方法结扎、不游离输尿管结扎、开腹腔但不结扎输尿管(假手术组)操作,术后14 d时比较组间大鼠肾间质纤维化成模率、死亡率、术后并发症发生率的差异;②另取28只SD大鼠,雌雄各半,随机分为改良组与假手术组,采用尿液分析、血细胞分析、血液生化分析方法,检测两组大鼠的生理指标,并通过苏木精-伊红染色与Masson染色法,观察改良组大鼠术后14,21 d时的肾脏组织病理学结果。 结果与结论：①与不游离输尿管结扎组大鼠相比,传统单侧输尿管梗阻组和改良单侧输尿管梗阻组大鼠的成模率高;②在单侧输尿管梗阻手术操作过程中,采用输尿管中段双结扎、中间不剪断的改良方法与传统方法相比,操作更简便易行,手术开创更小,肾间质纤维化成模快、成模率较高,动物术后死亡率与并发症发生率均低;③改良组与假手术组相比,术后14 d时的尿素氮、谷草转氨酶、白蛋白等血液生化指标差异有显著性意义(P < 0.05),其梗阻侧肾脏的组织病理切片苏木精-伊红染色与Masson染色结果均可见典型的肾间质纤维化病理特征。 ORCID: 0000-0001-7823-2897(孙杰) 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

34例鹿角形肾结石手术取石的疗效观察

目的探讨肾下极肾盂肾盏联合切开术治疗复杂性鹿角形肾结石的疗效。方法回顾性分析采用肾下极肾盂肾盏联合切开术式治疗复杂性鹿角形肾结石34例临床资料。手术方法:分离肾窦内肾盂后,用1-0肠线在肾后唇中下1/3连接处紧贴肾盂肾盏表面缝合肾实质2针,中间尖刀切开肾实质,然后弧形切开肾盂及肾下盏,用神经剥离子将结石与肾盂肾盏粘膜粘连分离后,取石钳夹住结石轻轻撬出。盏颈狭窄者必要时先用气压弹道碎石器将其在分支处击断。4-0肠线缝合肾盂及肾下盏,再用2-0肠线间断全层缝合肾实质切口数针,包膜层用4-0肠线缝合。结果34例均一次性取净结石。术中平均出血量约90ml。术后无大出血病例。结论肾下极背侧肾实质与肾盂联合切开取石术具有术中出血少,无须阻断肾蒂,肾功能受损轻,便于一次取尽结石等优点。适合于肾窦内肾盂特别是肾下盏盏颈相对狭窄的复杂性鹿角形肾结石的治疗。     

腰椎弓根延长术截骨部位与神经根关系的解剖学研究

目的　观察腰椎弓根延长术截骨部位与其毗邻神经根的解剖关系,为腰椎弓根延长术离断椎弓根提供解剖数据。  方法　16例成人防腐脊柱标本, 自T12~S1去除软组织、棘突、椎板、关节突关节、横突, 充分暴露硬膜囊、神经根和腰椎弓根, 精细磨削椎弓根至椎弓根-椎体连接处,测量该部位椎弓根上缘至上位神经根下缘的间距(PSRD),椎弓根下缘至下位神经根上缘的间距(PIRD),椎弓根内缘至硬膜囊外缘或内侧神经根外缘的间距(PMRD),椎弓根外缘至外位神经根内缘的间距(PLRD),所有解剖参数都做双侧测量。  结果　腰椎弓根至上、下、内、外神经根的间距范围分别是4.9~8.6 mm,1.0~2.5 mm,0~1.6 mm,0.7~11.5 mm,左、右两侧数据无显著性差异(P>0.05),男、女之间数据无显著性差异(P>0.05)。  结论　腰椎弓根截骨延长时,截骨部位的内缘和下缘毗邻的神经根相对于上缘和外缘损伤可能性大,透视下对椎弓根内缘和下缘截骨时要十分小心。     

肾盂输尿管连接处梗阻的手术治疗

目的：探讨肾盂输尿管连接处梗阻的诊治经验.方法：本组48例中,26例采用离断性肾盂成形术（Anderson-Hynes术）,2例行肾切除,20例行非离断性肾盂成形术（其中9例行V-Y肾盂成形术,6例单纯粘连带切断松解术,5例粘连处松解加肾盂裁剪）.结果：本组中40例随访3个月～2a,包括非离断性肾盂成形术16例,其中10例治愈（62.5%）,4例无效,2例加重;离断性肾盂成形术24例,其中21例治愈（87.5%）,3例加重.两种手术方法的疗效比较有显著性差异（P＜0.01）.结论：离断性肾盂成形术是治疗肾盂输尿管连接处梗阻的首选术式.     

数字X射线断层融合技术在静脉肾盂造影中的应用研究

目的探讨数字X射线断层融合(DTS)在静脉肾盂造影(IVP)中的应用价值。方法选择2014年4月至8月在南方医科大学南方医院接受IVP检查87例患者,其中男性49例,女性38例;年龄20~68岁,中位年龄40岁。行IVP及DTS,回顾性分析图像特征。结果 87例常规IVP检查中发现泌尿系结石42例,其中肾结石22例,输尿管结石16例,尿道结石4例。IVP联合DTS检查发现泌尿系结石65例,其中肾结石32例,输尿管结石27例,尿道结石6例,肾囊肿3例。IVP、IVP联合DTS检出结石阳性检出率分别为48.3%、74.7%。DTS均能清晰显示肾脏位置、大小、形态、密度、边缘,降低肠道伪影干扰,减少重叠区。IVP只能显示重复肾盂肾盏结构紊乱,DTS清晰可见重复肾盂肾盏。DTS可清晰显示尿道结石和输尿管内<1 cm的结石,但IVP未能显示。结论 DTS的阳性检出率明显高于常规IVP,能更清晰地显示双肾盂、输尿管、膀胱,是对IVP一种重要补充。     

上颌窦区的解剖研究及其临床意义

目的：为经上颌窦入路翼腭窝手术提供解剖学依据。方法：在15例成人尸头标本中观察并测量眶下孔至上颌窦重要结构之间的距离。结果：眶下孔位于眶下缘中点稍内侧,至眶下缘的垂直距离为（6．72±2．98）（4．30～11．90）mm,至上颌窦底壁的距离为（18．56±3．14）（14．60-27．20）mm,至上颌窦最后壁的距离为（36．08±3．61）（30．30-42．40）mm,至蝶腭动脉起始处的距离为（37．59±3．75）,（30．50～44．10）mm,至翼腭神经节的距离为（40．47±2．74）（36．10～44．90）mm,至翼管的距离为（48．12±3．21）（42．20-54．40）mm,至上颌神经出圆孔处的距离为（43．24±3．32）（38．90～49．70）mm;筛上颌窦板长径为（8．96±2．87）（4．10-13．10）mm,宽径为（5．28±1．38）（2．90-8．70）mm。结论：本研究可为经上颌窦入路翼腭窝手术提供解剖学参数。     

CT测量成人寰枢椎后方部分结构数据设计寰枢椎板间融合器

文题释义： 寰枢椎脱位：可分为可复性、难复性和不可复性脱位3种类型，其可导致C_1/2水平脊髓压迫而造成神经功能障碍症状，临床上多需要进行手术治疗，后路钉棒固定融合术是最常用的手术方式。 寰枢椎板间融合器：与寰枢椎侧块关节融合器不同，其直接固定在寰椎后弓与枢椎椎板骨面上，是一种新型融合器，此融合器可配合广泛使用的后路钉棒内固定手术，置入简便，增加植骨与寰椎后弓及枢椎椎板骨面的接触应力，促进骨性融合。 背景：寰枢椎融合器一直以侧块关节融合器为研究热点，但其置入操作风险过大，目前临床上一直缺乏可广泛应用的寰枢椎融合器。 目的：探究成人后路寰枢椎板间融合器的CT影像解剖学可行性并给出初步设计。 方法：对100例成人(男50例，女50例)寰枢椎CT三维成像进行测量，测量指标包括寰椎单侧后弓长度、寰椎后弓厚度、枢椎单侧椎板长度、枢椎椎板厚度、寰椎后弓上缘至枢椎椎板下缘距离，分析寰枢椎后方部分结构的CT测量数据并设计寰枢椎板间融合器。 结果与结论：①男、女性的寰椎单侧后弓长度分别为(23.41±1.48) mm和(22.23±1.25) mm，寰椎后弓厚度分别为(6.00±0.96) mm和(5.28±0.78) mm，枢椎单侧椎板长度分别为(18.54±2.23 )mm和(17.31±0.91) mm，枢椎椎板厚度分别为(5.12±1.31) mm和(4.98±1.26) mm，寰椎后弓上缘至枢椎椎板下缘距离分别为(32.63±2.76) mm和(31.39±4.04) mm；②不同性别的双侧测量数据差异无显著性意义(P > 0.05)；男性的寰椎单侧后弓长度、寰椎后弓厚度、枢椎单侧椎板长度大于女性，差异有显著性意义(P < 0.05)；男性与女性的枢椎椎板厚度、椎后弓上缘至枢椎椎板下缘距离差异无显著性意义(P > 0.05)；③寰枢椎后方部分结构的CT测量结果提示寰枢椎板间融合器是可行的；④寰枢椎板间融合器初步设计成功，并获得国家专利；⑤提示寰枢椎板间融合器具有应用可行性，可用于寰枢椎后路钉棒固定融合过程中，提升寰枢椎间的植骨融合率。 ORCID: 0000-0002-2101-1900(邹小宝)中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

Analysis of heparinization methods during hemodialysis

The ideal method of heparinization should achieve therapeutic concentrations (0.2-0.5 IU/mL) in the artificial kidney and the least possible amount of heparin in the patient. Total heparinization using a bolus dose (8400 IU) followed by continuous infusion of heparin (20 IU/min), initially showed 1.4-2.4 IU/mL in the artificial kidney and the patient, but unpredictable slopes. High-dose regional heparinization (120-144 IU/min) and neutralization showed sustained heparin concentrations (0.4-0.6 IU/mL) in the artificial kidney, and less than 0.2 IU/mL in the patient. Low-dose regional heparinization (25 IU/min) initially showed 0.25-0.45 IU/mL in the artificial kidney, but unpredictable slopes in the patient. Low-dose regional heparinization (25 IU/min) and neutralization showed sustained heparin concentrations (0.15-0.35 IU/mL) in the artificial kidney and less than 0.15 IU/mL in the patient.     

Enfuvirtide does not require dose adjustment in patients with chronic kidney failure: results of a pharmacokinetic study of enfuvirtide in HIV-1-infected patients with impaired kidney function

OBJECTIVE: The aim of this study was to examine the influence of kidney disease and hemodialysis on the pharmacokinetics ofenfuvirtide. DESIGN: An open-label, multicenter, parallel group study of HIV-1-infected patients with varying degrees of kidney dysfunction. METHODS: A 90-mg dose of enfuvirtide was administered by subcutaneous injection to 3 groups of patients: group A, patients with normal kidney function; group B, patients with chronic kidney disease; and group C, patients with end-stage renal disease (ESRD) requiring dialysis. Patients with ESRD requiring dialysis received the 90-mg dose of enfuvirtide on 2 separate occasions; a dialysis day and a nondialysis day. After each dose, a full 48-hour pharmacokinetic profile was collected and pharmacokinetic parameters were estimated using model-independent techniques. RESULTS: Enfuvirtide area under the curve (AUCinfinity) and maximum observed enfuvirtide plasma concentration (Cmax) for patients with normal kidney function (group A) was 49.6 microg h/mL and 3.79 microg/mL, respectively. Patients with chronic kidney disease (group B) had higher AUCinfinity (80.3 microg h/mL) and Cmax (5.72 microg/mL), which was similar to patients with ESRD (group C) on both nondialysis days (AUCinfinity 71.1 microg h/mL; Cmax 5.34 microg/mL) and dialysis days (AUCinfinity 66.9 microg h/mL; Cmax 6.31 microg/mL). An average of< 13% of enfuvirtide was removed during the dialysis procedure. The incidence of adverse events was comparable for all study groups. CONCLUSION: Enfuvirtide exposure observed in patients with ESRD requiring dialysis or chronic kidney disease was slightly higher than in patients with normal kidney function and similar to historical Cmax and AUC values from studies in patients with normal kidney function. Thus, enfuvirtide does not require dosage adjustment in patients with impaired kidney function.     

Simplified Stereological Evaluation of Renal Morphology after Unilateral Ureteral Obstruction

Objective and methods: This study established a simple stereological method to obtain quantitative information about two- or three-dimensional structures based on observations from kidney sections in the unilateral ureteral obstruction(UUO) model. Results: Tubulointerstitial area(TA) and TA/the area of a rectangular field(RA) were raised gradually, but significantly, in the obstructed kidney from 1 to 3months post-ligation in comparison to the sham kidney of sham-operated rats(SOR). On the contrary, glomerular area(GA) and glomerular volume(GV) were decreased progressively over time, but significantly, in the obstructed kidney from 3weeks to 3months post-ligation compared to the sham kidney of SOR. UUO caused a progressive decline of TA and TA/RA in the contralateral kidney. More specifically, there were significant decreases in TA at 1,2,3months post-ligation, while in TA/RA only at 3months post-ligation in comparison to the right kidney of SOR. In contrast, GA and GV enhanced in a time-dependent manner in the contralateral kidney, in which the difference in GA reached significance only at 3months post-ligation, whereas the difference in GV reached significance from 1 to 3months post-ligation when comparing with the right kidney of SOR. Conclusions: Our results confirmed two typical features of obstructive nephropathy, including widen interstitial space and glomerular atrophy in the obstructed kidney, and compensatory growth of the contralateral kidney.     

同种肾组织移植改善肾性贫血的基因水平检测

背景：促红细胞生成素分泌不足使慢性肾衰所引起的贫血(肾性贫血)难以改善。 目的：观察肾组织移植对肾性贫血大鼠促红细胞生成素基因表达的影响。 方法：80只Wistar大白鼠随机均正常对照组,病例对照组、重组人类促红细胞生成素组和肾组织移植组,后3组建立慢性肾功能衰竭动物模型。 结果与结论：60 d时移植组血红蛋白水平及血清促红细胞生成素高于病例对照组(P < 0.05),与重组人类促红细胞生成素组比较,差异无显著性意义(P > 0.05)。移植组肾组织EPO mRNA表达显著高于病例对照组,差异有显著性意义(P < 0.05)。提示肾组织移植改善肾性贫血的作用机制是促进肾组织EPO mRNA的基因表达,使肾脏合成促红细胞生成素增多,从而提高血红蛋白水平。     

Comparison of different tissue cultures for isolation and quantitation of influenza and parainfluenza viruses.

Rhesus and cynomolgus monkey kidney tissue cultures and two continuous lines, Madin-Darby canine kidney (MDCK) and LLC-MK2, were compared in titrations and isolations of influenza and parainfluenza viruses. Tube cultures were inoculated with laboratory virus strains or stored patient specimens and observed for hemadsorption. Trypsin was added to the medium of the continuous lines to increase sensitivity. All four tissue cultures gave similar titers of influenza A/USSR (H1N1), A/Texas (H3N2), and B/HK, but lower titers of parainfluenza 1, 2, and 3 were observed with MDCK. Cynomolgus kidney was the best single tissue culture for reisolation of the six viruses, but foamy-virus contamination of many lots was a serious problem. Reisolation of influenza viruses was as successful with MDCK as with primary monkey kidney. LLC-MK2 was similar to rhesus kidney but less successful than cynomolgus kidney. For reisolation of parainfluenza viruses, LLC-MK2 was superior to rhesus monkey kidney and similar to cynomolgus kidney. MDCK was less useful for parainfluenza viruses. Thus, LLC-MK2 would be an acceptable single tissue alternative to primary monkey kidney. The combination of MDCK and LLC-MK2 would provide optimal sensitivity for isolation of all six viruses.     

Rejection of an HL—A Identical Renal Transplant

A 38-year-old man suffering from chronic glomerulonephritis received a kidney from his HL—A identical sister. The HL—A identity was fully established by tissue typing with well-specified antisera and by mixed lymphocyte culture tests. One year after transplantation kidney function deteriorated, and repeated biopsies of the transplant, I¹³¹-Hippuran renography, and arteriography showed that the kidney was undergoing a chronic rejection. It is suggested that incompatibilities with regard to weak histocompatibility systems might have been responsible for the rejection of a human kidney.     

Participation of Vβ4+-, Vβ7+-, and Vβ11+-T Lymphocytes in Haematogenously Acquired Staphylococcus aureus Nephritis

The most frequent pathogen in haematogenously acquired kidney infections in humans is Staphylococcus aureus . In order to characterize in situ the immunological patterns of septic nephritis we developed a murine model of this disease. A single intravenous injection of S. aureus producing toxic shock syndrome toxin-1 resulted in high frequency of inflammatory kidney lesions. Histopathologically, both focal and diffuse inflammatory infiltrates were seen in kidney cortex and medulla. Immunohistochemical evaluation revealed high numbers of Mac-1⁺ phagocytic cells as well as CD4⁺- and CD8⁺-lymphocytes. The expansion of lymphocytes carrying T-cell receptor V_β chain 4, 7, and 11 families in the kidney was observed. Our results suggest that the haematogenously acquired kidney infection by superantigen-producing staphylococci leads to migration, in situ activation and expansion of responding T-lymphocyte subsets.     

NAD+-dependent 15-hydroxyprostaglandin dehydrogenase activity in kidney tissue from NZB/NZW F1 hybrid mice.

Prostaglandins, or related compounds, as well as estrogen and androgen are believed to be involved in the processes that lead to the development of murine lupus erythematosus (LE) in NZB/NZW F1 hybrid mice. In this investigation we measured NAD+-dependent 15-hydroxyprostaglandin dehydrogenase (PGDH) activity in kidney tissue of male and female NZB/NZW F1 hybrid mice and in kidney tissue of male and female mice of other strains. In each case the specific activity of PGDH was significantly greater in kidney tissue of male than in kidney tissue of female mice. However, the specific activities of PGDH in kidney tissues of males of various strains of mice were similar, and the specific activities of PGDH in kidney tissues of females of various strains-including the NZB/NZW F1 hybrid- were similar. Thus, while the lower activity of PGDH in kidney tissues of the female may be important in the pathogenesis of LE, the lower activity of this enzyme is not unique to the kidney of the female NZB/NZW F1 hybrid mouse.     

Sodium excretion in goldblatt hypertension

Summary Separate kidney function with special attention to sodium excretion was studied during 18 days in hypertensive rats with unilaterally constricted renal artery. For urine collection the bladder was divided into two separate chambers and drained by a new simple technique. Urinary flow rate of the untouched kidney was always elevated as compared to the clamped kidney. However the clearance of PAH and inulin of the untouched kidney was higher than that of the clamped kidney only during the first postoperative days and during saline intake. The osmolality and the inulin and potassium concentration were usually higher in the urine from the clamped kidney, whereas sodium concentration was higher in the urine from the contralateral kidney. Sodium excretion of the untouched kidney was not only greater than that of the clamped kidney but even greater than that of a normotensive control kidney. On the other hand sodium excretion of the clamped kidney was less than that of a normal kidney. Thus, total renal sodium output of the hypertensive and the normotensive rats did not differ. The reduced sodium excretion of the clamped kidney is interpreted as a consequence of the exaggerated sodium excretion of the untouched kidney, which is exposed to the high blood pressure.Preliminary results of this study have been presented at the Seventh Symposion of the Nephrological Society, Tübingen 1970.Supported by the Deutsche Forschungsgemeinschaft im Rahmen des SFB 89 Kardiologie Göttingen.     

肾移植后贫血因素分析：同一机构10年826例移植者资料回顾

背景:临床上肾移植后贫血发生率为30%~40%,是肾移植后心血管疾病和移植肾失功的重要危险因素,并且是患者死亡的独立预测指标。 目的：分析肾移植后贫血发生的相关因素。 方法：分析2000-01/2009-12解放军沈阳军区总医院肾移植826例患者资料,其中男541例,女285例,年龄17~71岁;尸体供肾805例,亲体活体供肾21例。根据移植后是否发生贫血将患者分成贫血组与非贫血组,记录可能引起移植后贫血的各项参数,分别用t检验和卡方检验进行单因素分析。 结果与结论：826例肾移植患者中发生贫血225例,发生率为27.2%。女性和男性患者贫血发生率分别为23%和37%(P < 0.05 );年龄26~65岁,其中伴有高血压应用血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体拮抗剂类降压药物者46例, 伴有慢性糜烂性胃炎或上消化道溃疡者16例,人存活率为85.3%,肾失功率为25.3%;非贫血组601例,占总例数的72.8%,其中男405例,女196例,年龄17~71岁,伴有高血压应用血管紧张素转化酶抑制剂或血管紧张素Ⅱ受体拮抗剂降压药物者35例,伴有慢性糜烂性胃炎或上消化道溃疡者14例,人存活率为92.1%,肾失功率为12.6%,与贫血组对比差异有显著性意义(P < 0.05)。分析表明,性别、年龄、肾功能、消化道疾病史、药物因素等与肾移植后贫血的发生密切相关。