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中国成年活体肾移植受者术后血小板减少症的患病率及危险因素

The prevalence and risk factors of thrombocytopenia after living-related renal transplantation in Chinese adult recipients.

作者信息

Xie L, He S, Fu L, Ashok K, Huang Z, Wang L, Lin T

机构信息

Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.

出版信息

Transplant Proc. 2013 Jan-Feb;45(1):197-9. doi: 10.1016/j.transproceed.2012.09.113.

Abstract

OBJECTIVE

To evaluate the prevalence of and risk factors for thrombocytopenia during the first year after living-related renal transplantation of Chinese patients.

METHODS

This retrospective study was performed in 274 adult kidney transplant recipients between January 2009 and December 2010. We followed each for ≥ 1 year. Posttransplant thrombocytopenia (PTT) was defined as a platelet (PLT) count ≤ 100 × 10(9)/mL at any time after transplantation; a severe case was considered to be <50 × 10(9)/mL. Possible risk factors for PTT were analyzed using univariate methods with key factors determined by multivariate analysis.

RESULTS

The prevalence of PTT was high (33.9%) during the first year, but severe PTT occured only among 4.0% of patients. The lowest PLT often happened in the first 3 months after the operation. Key risk factors associated with PTT were induction therapy (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3-4.1; P = .005) and infection (OR, 2.2; 95% CI, 1.3-3.8; P = .004) upon multivariate analysis. Severe PTT correlated with induction therapy (OR, 9.9; 95% CI, 1.7-56.2; P = .010) and acute rejection episodes (OR, 7.8; 95% CI, 1.4-42.4; P = .018).

CONCLUSIONS

PTT was quite prevalent in the first year after renal transplantation. Most recipients showed the lowest PLT count in the first 3 months. However, severe cases, which correlated with induction therapy and acute rejection episodes, were rare.

摘要

目的

评估中国患者亲属活体肾移植术后第一年血小板减少症的患病率及危险因素。

方法

本回顾性研究纳入了2009年1月至2010年12月期间的274例成年肾移植受者。对每位患者随访≥1年。移植后血小板减少症(PTT)定义为移植后任何时间血小板(PLT)计数≤100×10⁹/mL;严重病例定义为<50×10⁹/mL。采用单因素方法分析PTT的可能危险因素,并通过多因素分析确定关键因素。

结果

第一年PTT的患病率较高(33.9%),但严重PTT仅发生在4.0%的患者中。最低PLT计数常出现在术后前3个月。多因素分析显示,与PTT相关的关键危险因素为诱导治疗(比值比[OR],2.3;95%置信区间[CI],1.3 - 4.1;P = .005)和感染(OR,2.2;95%CI,1.3 - 3.8;P = .004)。严重PTT与诱导治疗(OR,9.9;95%CI,1.7 - 56.2;P = .010)和急性排斥反应发作(OR,7.8;95%CI,1.4 - 42.4;P = .018)相关。

结论

肾移植术后第一年PTT相当普遍。大多数受者在术后前3个月PLT计数最低。然而,与诱导治疗和急性排斥反应发作相关的严重病例很少见。

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