目的探讨影响移植肾功能延迟恢复(DGF)的相关因素。方法收集肾移植受者150例临床资料,其中24例发生DGF,对可能影响DGF发生的各项指标进行统计学分析。提取移植肾供者172例和健康体检者157例外周血中基因组DNA,应用多重PCR和特异性引物多态PCR技术检测谷胱甘肽硫转移酶(GST)基因多态性,比较DGF和无DGF组供者GST基因多态性的差异。结果受者DGF组和非DGF组性别(x^2=0.028,P=0.867)、PRA(X^2=1.564,P=0.211)及透析类型(X^2=0.585,P=0.444)之间比较差异无统计学意义(P〉0.05);单因素线性回归分析提示术后第2个24h尿量、第1和第2个24h人量与T1,2(SCr)间存在线性关系(P〈0.05),Cox风险比例回归模型提示术后第2个24h尿量可判断受者移植肾功能的恢复情况(RR=1.002,P=0.001)。DGF组供者GsTM1基因型缺失频率为86.4%,与未发生DGF组的62.7%、健康对照组的47.8%比较差异有统计学意义(P〈0.05)。结论受者术后第2个24h尿量对预测DGF的发生有重要意义。供者GsTM1基因型缺失可能是发生DGF的原因之一。
Objective To explore the factors related to the delayed graft function (DGF). Methods Clinical data of 150 recipients were collected and performed by Cox proportional hazards regression analysis . In addition, the glutathione S-transferase (GST) gene polymorphism of 172 donors and 157 healthy persons was analyzed by multiple PCR and SSP-PCR. Results DGF was observed in 24 patients among 150 recipients. Pretranplantation dialysis mode, PRA levels and recipient gender were uncorrelated with the incidence of DGF(P〉0.05). Urinary volume of the second 24 hours after transplantation was an independent predictor of DGF(RR: 1. 002, P= 0. 001). The frequency of donor's null GSTM1 in DGF group was significantly higher than that in non-DGF group(P〈0. 05). Conclusions Urinary volume of the second 24 hours after transplantation could he a predictor for DGF. The null GSTMI in donor might be one of the factors related to the EGF.