X线结合血生化检查对移植肾功能损害临床监测意义.docVIP

X线结合血生化检查对移植肾功能损害临床监测意义作者单位：650051 昆明医学院附属延安医院 云南心血管病医院（贺宇平，姚晓辉）；延安医院呈贡新区医院 通讯作者：贺宇平 【摘要】 目的 探讨胸部X线结合临床血生化检查对患者移植肾功能损害的临床监测意义。方法 对21例同种移植肾功能损害患者的X线胸片和BUN、SCr等主要血生化指标及临床表现进行回顾性分析。结果 移植肾术后加速排斥反应（ACR）2例X线表现：心影增大、中央型肺水肿、心包及胸腔积液、血管蒂（VPW）宽径61～64 mm。急性排斥反应（AR）3例X线表现：心影略增大，弥漫性肺水肿2例、单翼状肺水肿1例、少量胸腔积液、VPW 56～60 mm。手术并发症致肾移植术失败1例X线表现：心影略大、弥漫性肺水肿、VPW 58 mm、肾周积液。移植肾慢性排斥反应15例X线表现：心脏左室增大6例，肺淤血或肺间质水肿11例，VPW 52～56 mm 12例。21例主要血生化指标BUN 8.5～22 mmol/L，SCr 143.82～928.8 μmol/L。结论 X线结合血生化检查对移植肾功能状况可作出基本判断，对移植肾功能损害有重要的临床监测意义。 【关键词】 移植肾； 排斥反应； X线计算机； 血生化指标； 血管蒂宽径 Clinical monitoring significance for impairment of the transplantation kidney function that combine x-ray with blood biochemical examination HE Yu-ping,YAO Xiao-hui,HE Ning.The Affiliated Yianan Hospital of Kunming Medical College,Angiocardiopathy Hospital of Yunnan,Kunming 650051,China 【Abstract】 Objective To evaluate the clinical monitoring significance for impairment of transplantation kidney function that combine x-ray with major blood biochemical examination.Methods X-ray chest films and major blood biochemical index（BUN SCr） in 21 cases with impairment of the allogeneic transplantation kidney function,as well as clinical manifestation were analyzed retrospectively.Results 21cases were taken to roentgenogram of chest and X-ray manifestation:Accelerate reject reaction（ACR） were found in 2 cases at postoperation of transplantation kidney,heart shadow enlargement,central type pneumonedema,pericardium and pleural effusion,Vessel pedicle width（VPW）61-64 mm.Acute rejection（AR） were found in 3 cases, among these cases that diffuse pneumonedema and slight enlarge of heart shadow in 2 cases,unilateral pneumonedema in 1 case,that found small amout pleura l effusion,and VPW56-60 mm.As a result of operative complication was found in 1 case,and that diffuse pneumonedema,slight enlargement of heart shadow and hydroperinephrosis,VPW58 mm.Chronic rejection of kidney transplantation were found in 15 cases,that left ventricle enlar