中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (18): 3267-3270.doi: 10.3969/j.issn.1673-8225.2010.18.009

• 肾移植 kidney transplantation • 上一篇    下一篇

零点肾穿活检：对供者临床资料与组织学异常情况的相关性分析

郭君其，徐子忠，吴卫真，杨顺良，谭建明   

  1. 福建医科大学福总临床医学院，福建省移植生物学重点实验室，福建省福州市  350025
  • 出版日期:2010-04-30 发布日期:2010-04-30
  • 通讯作者: 谭建明，主任医师，教授，解放军南京军区福州总医院泌尿外即全军器官移植中心，福建省福州市 350025 doctortjm@yahoo.com
  • 作者简介:郭君其☆，男，1967年生，内蒙古自治区包头市人，汉族，2001年解放军第一军医大学毕业，博士，副主任医师，主要从事肾脏移植的研究。 guojunq2002@yahoo.com.cn
  • 基金资助:

    福建省科技创新平台建设计划(2008J1006)，解放军南京军区医学科技创新项目(09MA093)。

Time-zero renal biopsy: Correlation analysis of clinical predonation parameters and histological abnormalities

Guo Jun-qi, Xu Zi-zhong, Wu Wei-zhen, Yang Shun-liang, Tan Jian-ming   

  1. Key Laboratory of Biology Transplantation, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Clinical Medical College of Fuijan Medical University, Fuzhou  350025, Fujian Province, China
  • Online:2010-04-30 Published:2010-04-30
  • Contact: Tan Jian-ming, Chief physician, Professor, Key Laboratory of Biology Transplantation, Fuzhou General Hospital of Nanjing Military Area Command of Chinese PLA, Clinical Medical College of Fuijan Medical University, Fuzhou 350025, Fujian Province, China doctortjm@yahoo.com
  • Supported by:

    The Platform Construction of Scientific and Technological Innovation Project of Fujian Province No.2008J1006*; the Medical Scientific and Technological Innovation Project of Nanjing Military Command, No. 09MA093*

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摘要：

背景：目前，活体肾脏捐赠的数量在全国乃至全世界范围内增长，因此，保障供者安全在亲体肾移植中占有重要地位。如何准确诊断移植供者可能存在的肾脏疾病，以指导供者手术后潜在肾脏病治疗和肾功能保护成为亲体肾移植后保障供者安全的重要课题。
目的：建立一种对供者捐肾前的临床资料与组织学异常情况间相关性的评价方法。
方法：对解放军南京军区福州总医院2008-02/2009-11所有亲属肾移植的相关数据做回顾性分析，于供肾血管离断并灌注完成后进行穿刺。用零点肾穿的方法评估下列病变：间质纤维化，小管萎缩，微小动脉透明变性，肾小球系膜增生和肾小球硬化。移植前的统计数据包括：体质量，体质量指数，收缩压/舒张压，血清肌酸酐，肾小球滤过率和蛋白尿。
结果与结论：62例供者术前检查均未发现明显肾脏疾病征象，零点肾穿活检发现肾脏病理改变28例，其中间质纤维化与收缩压和肌酐清除率，肾小管萎缩与舒张压和尿蛋白，小动脉透明样变与肌酐和肾小球滤过率，肾小球系膜增生和体质量指数具有弱相关性，肾小球硬化与其他变量均无相关性。

关键词: 零点肾穿, 肾脏移植, 活体供肾者, 病理, 临床资料

Abstract:

BACKGROUND: The number of living renal donation has increased in China and abroad, thus, it is important to guarantee the safety of donors. How to accurately diagnose potential renal disease and provide guidance plays an import role in protecting safety of living renal donors.
OBJECTIVE: To establish an evaluation method for analyzing the correlation between histological abnormalities and clinical predonation parameters.
METHODS: The related data on renal transplantation of Fuzhou general Hospital of Nanjing Military Area Command of Chinese PLA were retrospectively reviewed. Paracentesis were performed when the vessels of kidney were mutilated and perfusions were finished. Time-zero renal biopsy was evaluated for following pathological changes: interstitial fibrosis, tubularatrophy, arteriolar hyalinosis, mesangial proliferation, and glomerulosclerosis. Predonation data were demography, body weight, body mass index, systolic/diastolic blood pressure, serum creatinine, glomerular filtration rate, and proteinuria.
RESULTS AND CONCLUSION: There were no signs of kidney disease in preoperative examination of all the 62 patients, time-zero renal biopsy found there were 28 donors with histological changes, interstitial fibrosis with age and serum creatinine, tubularatrophy with diastolic blood pressure and protein excretion rate, arteriolar hyalinosis with serum creatinine and glomerular filtration rate, mesangial proliferation only with body mass index, and finally the presence of glomerulosclerosis did not correlate with any variable.

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