Kasiske B L
Department of Medicine, Hennepin County Medical Center, Minneapolis, MN 55415.
Miner Electrolyte Metab. 1993;19(3):186-95.
The incidence of cardiovascular disease is high after renal transplantation. Risk factors include pretransplant cardiovascular disease, diabetes, male sex, serum cholesterol, hypertension, cigarette smoking, and allograft dysfunction. Prevention of cardiovascular disease can probably best be approached by modifying multiple risk factors. Thus, efforts should be made to identify and treat patients with severe coronary artery disease before transplantation. After transplantation, hypertension and hyperlipidemia should be treated, and efforts should be made to help patients abstain from smoking. Chronic immunosuppression protocols should attempt to balance the need to prevent allograft rejection with the known adverse effects of immunosuppressive agents on cardiovascular disease. Altogether, an aggressive, coordinated program to modify multiple risk factors is probably the best approach to the prevention of cardiovascular disease after renal transplantation.
肾移植后心血管疾病的发病率很高。危险因素包括移植前心血管疾病、糖尿病、男性、血清胆固醇、高血压、吸烟和同种异体移植功能障碍。预防心血管疾病最好的方法可能是改变多个危险因素。因此，应努力在移植前识别并治疗患有严重冠状动脉疾病的患者。移植后，应治疗高血压和高脂血症，并努力帮助患者戒烟。慢性免疫抑制方案应试图在预防同种异体移植排斥反应的需求与免疫抑制剂对心血管疾病的已知不良影响之间取得平衡。总之，一个积极的、协调的改变多个危险因素的方案可能是预防肾移植后心血管疾病的最佳方法。
