查詢結果分析
來源資料
頁籤選單縮合
題名 | The Change of Creatinine Ratio of Urine to Plasma in Renal Transplant Recipients=腎移植病人尿中和血中肌酸酐濃度比例之變化 |
---|---|
作者 | 胡瑞恆; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 25:4 民81.07-08 |
頁次 | 頁1241-1247 |
分類號 | 416.273 |
關鍵詞 | 腎移植病人; 肌酸酐濃度; |
語文 | 英文(English) |
中文摘要 | 我們回顧台大醫院自1988年元月至1990年12月所施之32例腎臟移植病人住院時之尿中和血中肌酸酐濃度比例(Cr U/P比)之變化,以觀察其在腎移植病人之意義。依其變化趨勢之不同,32位病人可分為三組:第一組有12人,他們的Cr U/P比在手術後五日內持續上升至25以上並維持穩定。其中10位病人病程順利而未發生任何合併症。第二組有11人,他們的Cr U/P比長時間維持在極低的值(絕大多數低於10,所有人均低於20)並且缺乏波動性。11人中有9人在手術後有急性腎小管壞死的現象,而且此低Cr U/P比和腎小管壞死之期間相配合。另二位病人的低Cr U/P比則是在急性排斥之後發生。第三組有11人(其中兩人亦包括在第二組中),他們的Cr U/P比在上升的過程中有一天之內突降8以上之情形,有10位病人在Cr U/P比降低後之一至三天在臨床上被診斷有急性排斥之情形。我們的結論是:Cr U/P比在腎臟移植病人是一個很好的指標,若其持續上升,我們可以推斷移植腎將有很好之功能(敏感度90.9%,精確度90.5%);若病人之Cr U/P比長時間處於極低值而無波動,我們可知此病人是處於一腎小管壞死之狀態(敏感度100%,精確度91.3%);更重要的是,當Cr U/P比在上升的趨勢中若發生一天中突降8以上的情形,我們可推測在三天內病人將有急性排斥之臨床表現(敏感度83.3%,精確度95.0%),故Cr U/P比亦是早期鬱斷急性排斥之指標之一。 |
英文摘要 | Thirty-two renal allograft recipients who received transplantation at the National Taiwan University Hospital from January 1988 to December 1990 are reviewed retrospectively on the creatinine ratio of urine to plasma (Cr u/p) after operation. The 32 patients can be divided into three groups according to the change of Cr u/p ratio during hospitalization. Group 1 are those patients with progressive elevation of Cr u/p ratio to over than 25 within 5 days (n=12). Ten of the 12 patients had smooth postoperative course without any complications. Group 2 are those patients with constant low Cr u/p ratio (less than 20) either immediately after operation or after a period of transient elevation of Cr u/p ratio (n=11). Nine of these 11 patients experienced delayed graft function after operation and the other two had acute rejection (AR) before the constant low Cr u/p ratio. Group 3 are those patients experienced an abrupt decline of Cr u/p ratio for more than 8 within 24 hours (n=11). Two of them also belong to group 2 because they had constant low Cr u/p ratio after the decline of the ratio. Ten of the eleven patients experienced acute rejection one to three days after the decline of the Cr u/p ratio. In conclusion, the Cr u/p ratio is a useful indicator for renal function in renal transplant recipients. As an indicator of smooth recovery, the progressive elevation of Cr u/p ratio has sensitivity of 90.9% and specificity of 90.5%. The constant low Cr u/p ratio is a characteristic finding of ATN with sensitivity of 100% and specificity of 91.3%. The abrupt decline of Cr u/p ratio for more than 8 within 24 hours as a predictor of AR has sensitivity of 83.3% and specificity of 95.0%, and the decline may be noted one to three days prior to the elevation of serum creatinine. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。