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肾移植受者中巨细胞病毒感染与动脉粥样硬化事件之间的关联。

The association between cytomegalovirus infection and atherosclerotic events in renal transplant recipients.

作者信息

Ozdemir F N, Akgul A, Altunoglu A, Bilgic A, Arat Z, Haberal M

机构信息

Department of Nephrology, Baskent University Hospital, Ankara, Turkey.

出版信息

Transplant Proc. 2007 May;39(4):990-2. doi: 10.1016/j.transproceed.2007.02.026.

Abstract

Cytomegalovirus (CMV) infection is a risk factor for arteriosclerosis in renal transplant recipients. We sought to investigate the effects of CMV infection on atherosclerotic events (AE) in renal transplant recipients. This retrospective analysis included 200 patients: 52 women and 148 men of overall mean age of 36.18 +/- 10.23 years who were transplanted at our center between 1998 and 2001. We analyzed demographic features, dialysis duration, diabetes, blood pressure level, body mass index (BMI), medications, and lipid parameters. CMV infection was diagnosed in 23.5% of patients in the first 2 years after transplantation; these patients were followed for 4 years. All patients had been assessed for AE, including previous myocardial infarction, angina, revascularization procedures, intermittent claudication, stroke, or transient ischemic attack. AE occurred in 13% during the follow-up period. CMV infection was more frequent among these patients compared to those without AE, namely 42.3% versus 20.6%, respectively. Although the gender, dialysis duration, serum cholesterol level, presence of acute rejection, and BMI were not associated with AE, age, hypertension, and CMV infection did show a relation. A multivariate analysis by logistic regression revealed mean age and CMV infection to be independent risk factors for AE: odds ratio (OR)=5.6, 95% confidence interval (CI)=1.3 to 24.6 (P=0.02) and OR=4, 95% CI = 1.3 to 12.3 (P=.01). This study suggested that the presence of CMV infection may be a triggering factor for AE in renal transplant recipients.

摘要

巨细胞病毒(CMV)感染是肾移植受者发生动脉粥样硬化的一个危险因素。我们试图研究CMV感染对肾移植受者动脉粥样硬化事件(AE)的影响。这项回顾性分析纳入了200例患者:52名女性和148名男性,总体平均年龄为36.18±10.23岁,于1998年至2001年在我们中心接受移植。我们分析了人口统计学特征、透析时间、糖尿病、血压水平、体重指数(BMI)、用药情况和血脂参数。23.5%的患者在移植后的前两年被诊断出CMV感染;这些患者被随访了4年。所有患者均接受了AE评估,包括既往心肌梗死、心绞痛、血运重建手术、间歇性跛行、中风或短暂性脑缺血发作。随访期间13%的患者发生了AE。与未发生AE的患者相比,这些患者中CMV感染更为常见,分别为42.3%和20.6%。尽管性别、透析时间、血清胆固醇水平、急性排斥反应的存在和BMI与AE无关,但年龄、高血压和CMV感染确实显示出相关性。逻辑回归多因素分析显示平均年龄和CMV感染是AE的独立危险因素:比值比(OR)=5.6,95%置信区间(CI)=1.3至24.6(P=0.02),OR=4,95%CI = 1.3至12.3(P=0.01)。这项研究表明,CMV感染的存在可能是肾移植受者发生AE的触发因素。

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