超重心脏移植受者的临床结局
Clinical outcomes in overweight heart transplant recipients.
作者信息
Jalowiec Anne, Grady Kathleen L, White-Williams Connie
机构信息
School of Nursing, Loyola University of Chicago, Chicago, IL, USA.
Center for Heart Failure, Bluhm Cardiovascular Institute, Division of Cardiac Surgery, Northwestern Memorial Hospital, Chicago, IL, USA; Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
出版信息
Heart Lung. 2016 Jul-Aug;45(4):298-304. doi: 10.1016/j.hrtlng.2016.03.005. Epub 2016 Apr 14.
BACKGROUND
Few studies have examined the impact of patient weight on heart transplant (HT) outcomes.
OBJECTIVES
Nine outcomes were compared in 2 groups of HT recipients (N = 347) based on their mean body mass index (BMI) during the first 3 years post-HT.
METHODS
Group 1 consisted of 108 non-overweight patients (BMI <25; mean age 52; 29.6% females; 16.7% minorities). Group 2 consisted of 239 overweight patients (BMI ≥25; mean age 52; 15.9% females; 13.8% minorities). Outcomes were: survival, re-hospitalization, rejections, infections, cardiac allograft vasculopathy (CAV), stroke, renal dysfunction, diabetes, and lymphoma.
RESULTS
Non-overweight patients had shorter survival, were re-hospitalized more days after the HT discharge, and had more lymphoma and severe renal dysfunction. Overweight patients had more CAV, steroid-induced diabetes, and acute rejections.
CONCLUSIONS
Overweight HT patients had better survival, but more rejections, CAV, and diabetes. Non-overweight HT patients had worse survival, plus more re-hospitalization time, lymphoma, and renal dysfunction.
背景
很少有研究探讨患者体重对心脏移植（HT）结局的影响。
目的
根据心脏移植术后前3年的平均体重指数（BMI），对两组心脏移植受者（N = 347）的9项结局进行比较。
方法
第1组由108名非超重患者组成（BMI <25；平均年龄52岁；女性占29.6%；少数族裔占16.7%）。第2组由239名超重患者组成（BMI≥25；平均年龄52岁；女性占15.9%；少数族裔占13.8%）。结局包括：生存率、再次住院、排斥反应、感染、心脏移植血管病变（CAV）、中风、肾功能不全、糖尿病和淋巴瘤。
结果
非超重患者的生存期较短，心脏移植出院后再次住院天数更多，且淋巴瘤和严重肾功能不全的发生率更高。超重患者的CAV、类固醇诱导的糖尿病和急性排斥反应更多。
结论
超重的心脏移植患者生存率更高，但排斥反应、CAV和糖尿病更多。非超重的心脏移植患者生存率更差，再次住院时间更长，淋巴瘤和肾功能不全的发生率更高。
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