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目的探讨60岁以上老年患者肾移植的临床特点,以及影响肾长期存活的因素。方法回顾性分析48例≥60岁老年肾移植患者的临床资料,并以同期<60岁的肾移植患者205例作对照。结果老年组人/肾1、3年存活率分别为89.6%/87.5%、79.1%/75.0%,对照组分别为92.7%/91.7%、81.0%/76.1%,两组比较差异无显著性统计学意义(P>0.05);老年组急性排斥反应发生率为10.4%,与对照组11.1%无显著性统计学差异(P>0.05);老年组术后肺部感染、心血管疾病、肝功能异常等的发生率均高于对照组(P<0.01)。老年组术后住院时间(28.0±11.7)d,显著高于对照组的(19.8±8.7)d(P<0.05)。结论老年患者进行肾移植时,心血管并发症和感染是引起死亡的主要原因。术前应慎重选择、充分准备、严格配型,术后合理使用免疫抑制剂、积极预防和及时处理并发症。
Objective To investigate the clinical features of renal transplantation in elderly patients over 60 years and the factors that affect the long-term renal survival. Methods The clinical data of 48 cases of elderly renal transplant recipients aged 60 years were retrospectively analyzed. The control group included 205 cases of renal transplant recipients <60 years old. Results The 1-year and 3-year survival rates in elderly patients were 89.6% / 87.5% and 79.1% / 75.0%, respectively, while those in the control group were 92.7% / 91.7% and 81.0% / 76.1% respectively. There was no significant difference between the two groups (P> 0.05). The incidence of acute rejection in the elderly group was 10.4%, which was not significantly different from that in the control group (11.1%) (P> 0.05). The incidence of pulmonary infection, cardiovascular disease, liver function The incidence of abnormalities were higher than the control group (P <0.01). The postoperative hospital stay in the elderly group was (28.0 ± 11.7) d, which was significantly higher than that in the control group (19.8 ± 8.7) days (P <0.05). Conclusions Cardiovascular complications and infection are the leading causes of death in elderly patients undergoing kidney transplantation. Preoperative choice should be carefully chosen, fully prepared, strict matching, postoperative rational use of immunosuppressive agents, and actively prevent and timely treatment of complications.