肾移植患者术后蛋白尿的临床诊治效果

目的 探讨肾移植受者术后蛋白尿临床诊治的效果,并观察其不良反应.方法 对131例肾移植术后蛋白尿患者行移植肾穿刺活体组织检查,根据不同病因应用糖皮质激素类药物或调整免疫抑制方案及改善微循环等相应临床治疗,评价其临床疗效和安全性.结果 治疗后24 h尿蛋白定量、血肌酐、肌酐清除率、血尿素氮分别为(0.48±0.36) g/L、( 119.88±34.15) μmon/L、( 82.23 ±48.79) ml/min、(4.42± 1.77) mmon/L,与治疗前比较,差异有统计学意义(P＜0.05)；治疗后排斥反应、新发/复发性肾小球肾炎和缺血再灌注损伤组的总有效率与无效率比较差异有统计学意义(P＜0.05)；治疗期间未发生严重不良反应.结论 根据移植肾穿刺结果,应用糖皮质激素类药物或者调整免疫抑制方案及改善微循环等药物治疗对肾移植术后蛋白尿进行治疗,其临床疗效好,不良反应较少.

Diagnosis and treatment of proteinuria after renal transplantation

Objective To investigate the efficacy of the clinical treatment and the situation of proteinuria after renal transplantation.Methods 131 patients with proteinuria after kidney grafting were needled biopsy.According to the causes of proteinuria after kidney biopsy,they were treated with glucocorticoid,adjustment of immunosuppressive regimens and improvement of microcirculation.Efficacy of the clinical treatment was then evaluated.Results After treatment,the contents of urinary protein,serum creatinine,rate of creatinine clearance,and the blood urea nitrogen were significantly different(P<0.05).There were also significant different between the total efficacy and invalid of rejection,nephritis and ischemic-reperfusion injury after treatment(P<0.05).Conclusion According to the causes of proteinuria after kidney biopsy,patients may be treated with glucocorticoid,by adjustment of immunosuppressive regimens or improvement of microcirculation.