心脏移植后功能下降及其对存活率的影响
Tasigan Chaemchoi1, Wannee Ittiwattanakul1, Puangpen Ritteeverakul1
1Department of Pharmacy, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
Clinical transplantation
|September 7, 2023
概括
功能下降影响20%的心脏移植接受者在一年内. 对这些患者和移植前糖尿病患者的早期干预对于预防透析和改善存活率至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 心脏病学 心脏病学
- 移植医学 移植医学
背景情况:
- 在亚洲人群中,心脏移植后功能下降 (HTx) 的数据有限.
- 研究HTx后功能下降的发病率和危险因素至关重要.
研究的目的:
- 为了确定HTx后功能下降的发生率.
- 为了确定与HTx后功能下降相关的风险因素.
- 评估功能下降对生存率的影响.
主要方法:
- 从2010年到2020年,对成年心脏移植患者的回顾性分析.
- 通过EGFR降低 (≥40%),EGFR<15毫升/分钟/1.73米2,肌素翻倍或透析定义的功能下降.
- 统计分析包括风险因素的危险比率和死亡率预测.
主要成果:
- 估计的淋巴膜过率 (eGFR) 的下降速度为每年3.9mL/min/1.73m2.
- 功能下降的累积概率在一年后达到22%,在5年后达到43%.
- 出院后1年内下降和移植前糖尿病是透析的独立风险因素;移植后透析预测死亡率.
结论:
- 大约20%的HTx患者在一年内经历了功能下降.
- 对于患有功能下降和移植前糖尿病患者,需要采取预防措施.
- 解决功能下降对于改善HTx后的长期生存至关重要.
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