中文摘要：

目的探讨肾移植术后心血管病（CVD）发生的危险因素。方法对2009年5月―2013年11月在解放军309医院行同种异体肾移植手术并符合纳入条件的1106例患者的病例资料进行回顾性分析,采用Cox比例风险模型分析移植术后CVD的危险因素。资料收集及随访时间点为术前及术后7d、1个月、3个月、6个月、12个月,之后每半年随访1次,直至2014年3月研究结束。结果共有216例（19.5%）肾移植受者术后发生CVD,其中47例（4.2%）发生于术后3个月内,125例（11.3%）发生于术后1年内,分别占术后CVD患者总数的26.8%和47.9%。51例（4.6%）受者死亡,其中19例（2.7%）死于CVD,占全部死亡患者的37.3%。多因素分析结果显示：受者年龄〉50岁（OR=2.39,95%CI 1.15～3.60）、术前有糖尿病（OR=3.18,95%CI 1.56～6.42）、术前有CVD病史（OR=3.85,95%CI 2.15～7.54）、原发疾病为糖尿病肾病（OR=2.12,95%CI 1.14～3.98）、术前透析时间〉12个月（OR=1.27,95%CI 0.98～1.38）、术后血清肌酐〉200μmol/L（OR=2.78,95%CI 1.35～4.53）、移植肾功能延迟恢复（DGF）（OR=1.24,95%CI 1.02～1.42）、急性排斥反应（AR）（OR=2.98,95%CI 1.56～5.72）、移植肾失功（OR=4.86,95%CI 3.15～7.78）是肾移植术后发生CVD的危险因素。结论肾移植术后CVD发病率较高,其危险因素呈多样化。对相关危险因素进行校正或去除,可能降低肾移植术后CVD发病率,有利于移植肾的长期存活。

英文摘要：

Objective To study the risk factors of occurrence of cardiovascular diseases （CVD） after renal transplantation. Methods The follow-up data of 1106 cases of renal transplantation, performed in 309 hospital of PLA from May 2009 to Nov. 2013, were retrospectively reviewed. The patients were evaluated for postoperative cardiac events, and the post-transplant risk factors of CVD were analyzed using the Cox proportional hazard model. Observation was done before operation, and 7d, 1st, 3rd, 6th and 12th month after transplantation, then once every half year, till march of 2014 as the end of the study. Results Tow hundred and sixteen patients （19.5%） developed at least one cardiovascular event in the post-transplant period. Forty-seven cases （6.32%） of primary CVD occurred during the first 3 months, and it occurred in 125 cases （11.30%） during the first year, which made up 26.81% and 47.89% of the total CVD patients. There were 19 patients died from CVD, which made up 37.3% of the 51 total death. Multivariate analysis showed that Age 〉 50 years （0R=2.39, 95% CI, 1.15-3.60）, existence of diabetes before transplantation （0R=3.18, 95% CI, 1.56- 6.42）, pre-transplantaion CVD （0R=3.85, 95% CI, 2.15-7.54）, diabetic nephropathy as the primary disease （OR--2.12, 95% CI, 1.14- 3.98）, pre-transplantation dialysis duration as long as 12 months （OR=1.27, 95% CI, 0.98-1.38）, post-transplantaion serum creatinine 〉200μmol/L （OR=2.78, 95% CI, 1.35-4.53）, delayed recovery of graft function （DGF） （0R=1.24, 95% CI, 1.02-1.42）, acute rejection （AR） （OR=2.98, 95% CI, 1.56-5.72） and graft renal failure （OR=4.86, 95% CI, 3.15-7.78） were the significant risk factors of CVD after renal transplantation. Conclusions The incidence of cardiovascular disease in patients under gone renal transplants continues to be high. Therefore, the multivariate risk factors of CVD should be identified and rectified in order to prevent occurrence of CVD in post transplant period, and promote the survi