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Eur J Heart Fail:心脏移植者晚期移植物衰竭的发生率、危险因素及临床结局!

2018-03-01 xing.T MedSci原创

由此可见,心脏移植后晚期移植物衰竭较为常见,因为它与不良结局有关。排斥反应和移植心脏血管病是最常见的原因。

近日,心血管领域权威杂志European Journal of Heart Failure上发表了一篇研究文章,研究人员旨在对心脏移植术后晚期移植物衰竭的发生率、危险因素及临床结局进行分析。

研究人员进行了一项观察性的单中心研究,研究对象是1991至2014年间接受心脏移植手术的547名术后存活的患者。晚期移植物衰竭被定义为出院后由于这种疾病首次住院。

在平均8.4 ± 6年的随访期间,178例(32.5%)患者接受住院治疗,由于晚期移植物衰竭[发生率为3.6例每100病人每年,95%可信区间(CI)为3.1-4.2]。移植前糖尿病、移植前高跨肺压梯度和较低的供者/受者重量比与移植物衰竭风险增加独立相关。移植心脏血管病变、细胞排斥反应等级≥1R和抗体介导排斥等级≥1级的患者比例分别为50.6%、44.9%和19.2%。其中60.1%的患者左室射血分数≥50%。诊断移植物衰竭后1年、5年、10年和15年的未再移植存活率分别为72.2%、38.4%、18.4%和7.5%,因失代偿性心衰再住院的发生率为每100名病人每年有40.9次(95%CI为36.6-46.1)。需要正性肌力药物治疗、存在移植心脏血管病变、较高的血清肌酐水平、较低的射血分数和较低的血清钠水平是预后较差的独立预测因素。

由此可见,心脏移植后晚期移植物衰竭较为常见,因为它与不良结局有关。排斥反应和移植心脏血管病是最常见的原因。

原始出处:


Ángela López-Sainz, et al. Late graft failure in heart transplant recipients: incidence, risk factors and clinical outcomes.European journal of heart failure. 2018. http://onlinelibrary.wiley.com/doi/10.1002/ejhf.886/full

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    2018-12-05 xuyong535
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    2018-03-02 zhaojie88
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    2018-03-02 slcumt
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    2018-03-01 wzb521zf

    一起学习学习

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