中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (31): 5729-5732.doi: 10.3969/j.issn.2095-4344.2012.31.007

• 肾移植 kidney transplantation • 上一篇    下一篇

亲属活体肾移植供者移植前行肺部CT检查的必要性

李金锋，丰贵文，王 跃，庞新路，尚文俊   

  1. 郑州大学第一附属医院肾移植科，河南省郑州市 450052
  • 收稿日期:2012-01-04 修回日期:2012-03-30 出版日期:2012-07-29 发布日期:2012-07-29
  • 通讯作者: 尚文俊，博士，主治医师，郑州大学第一附属医院肾移植科，河南省郑州市 450052
  • 作者简介:李金锋☆，男，1980年生，河南省延津县人，汉族，2009年复旦大学毕业，博士，主治医师，主要从事肾移植研究。

Necessity for lung CT in potential related living kidney donors

Li Jin-feng, Feng Gui-wen, Wang Yue, Pang Xin-lu, Shang Wen-jun   

  1. Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
  • Received:2012-01-04 Revised:2012-03-30 Online:2012-07-29 Published:2012-07-29
  • Contact: Shang Wen-jun, M.D., Ph.D., Attending physician, Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China shangwj111@163.com
  • About author:Li Jin-feng☆, M.D., Ph.D., Attending physician, Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China jinfenglis512@126.com

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摘要：

背景：亲属肾移植供者年龄较大会有一定肺部疾病发病率。
目的：了解亲属活体供者肺部疾病的发生率进而探讨亲属活体供者移植前行肺部CT检查的必要性。
方法：纳入郑州大学第一附属医院自2009-07/2011-04拟行亲属供肾切取的127例亲属肾移植供者，排除捐献禁忌证如高血压、糖尿病及供受者血型不符后，常规行胸部CT及X射线检查。由2位放射科医师结合临床表现讨论后对胸部CT及X射线结果作出诊断，评价肺部检查结果对供肾移植的影响。
结果与结论：127例供者常见肺部疾病依次为肺炎(15.0%)、肺气肿(7.9%)、肺实质钙化(6.3%)、胸膜增厚(3.1%)、胸膜粘连(3.1%)。除钙化外肺部CT检查比X射线可以更敏感的监测出各种肺部疾病(P < 0.05)。此外，供者肺炎冬季发生率比夏季高(P < 0.05)，有吸烟史供者肺气肿发生率高于无吸烟史供者(P < 0.01)。绝大多数肺部疾病并不影响活体供肾手术的进行，仅有1例治疗无效的间质性肺炎供者放弃手术。结果证实，肺部疾病在亲属肾移植供者中有较高发生率，有吸烟史或手术安排在冬季进行的供者移植前有必要行CT检查。

关键词: 肺部疾病, 肾移植, 活体供者, CT, X射线

Abstract:

BACKGROUND: Related donors for kidney transplantation have high age, with a certain incidence rate of pulmonary disease.
OBJECTIVE: To evaluate the incidence rate of thorax abnormalities among a cohort of potential living kidney donors and assess the necessity of routinely performing thorax computed tomography.
METHODS: 127 potential living donors at the First Affiliated Hospital of Zhengzhou University who underwent thorax computed tomography and chest radiography as part of their kidney donor evaluation ranging from July 2009 to April 2011 were identified. Subjects with hypertension, diabetes and blood type incompatibility were excluded. Their radiographic data were reviewed for abnormalities by two radiologists. The effects on approval for kidney donation were also determined.
RESULTS AND CONCLUSION: Among 127 potential kidney donors, the most common abnormalities were pneumonia (15.0%), emphysema (7.9%), parenchymal scarring-fibrosis (6.3%), pleural thickening (3.1%), and pleural effusion (3.1%). CT identified thorax problems more often than did chest radiography except for fibrosis (P < 0.05). Furthermore, pneumonia occurred in a higher proportion in the winter (P < 0.05), while emphysema occurred in a higher proportion in the donors with smoking history (P < 0.01). Nevertheless, the majority of imaging findings are not perceived to be harmful enough to prevent kidney donation, only one case with interstitial lung disease was excluded from donation after poor response to treatment protocol. Results verified that incidental radiographic abnormalities of thorax are common in potential living donors. Living donors, especially smokers or operating in winter season should routinely undertake thorax CT before the operation.

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