2022 年第 1 期 第 17 卷

心脏移植受者术后中远期疗效及死亡危险因素分析

Analysis of mid- to long-term efficacy and risk factors for death in patients after heart transplantation

作者：李雨琪1贾明1韩杰2叶青2张海波2

英文作者：Li Yuqi1 Jia Ming1 Han Jie2 Ye Qing2 Zhang Haibo2

单位：1首都医科大学附属北京安贞医院心脏外科危重症中心，北京100029；2首都医科大学附属北京安贞医院心脏外科，北京100029

英文单位：1Cardiac Surgery Intensive Care Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Department of Cardiac Surgery Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心脏移植；生存率；危险因素

英文关键词：Hearttransplantation;Survivalrate;Riskfactorssplantation

• 摘要：

• 目的 探讨心脏移植受者术后中远期疗效及死亡的危险因素。方法 回顾性收集首都医科大学附属北京安贞医院2001年3月至2017年12月行心脏移植术的211例患者临床资料及手术结果，另65例外院手术患者缺失术前术中资料，但定期至本中心复查，纳入随访结果，所有患者随访至2019年12月31日。采用Kaplan-Meier方法 统计中远期生存率，采用Cox生存分析方法 分析影响心脏移植受者中远期存活的危险因素。结果 本中心211例心脏移植受者住院时间（35±19）d，术后院内时间（21±10）d，围术期死亡16例，195例本中心出院患者及65例外院患者共计260例，术后随访期间死亡58例。260例受者中位生存期142个月，术后1、3、5、7、10年的存活率分别为94.7%、90.6%、86.8%、80.4%和74.1%。吸烟史、术前血肌酐、天冬氨酸转氨酶及空腹血糖水平是影响受者术后中远期存活的危险因素（均P＜0.05）。结论  吸烟史、术前血肌酐、天冬氨酸转氨酶及空腹血糖水平是影响心脏移植受者中远期存活的危险因素。

• Objective   To investigate the mid- to long-term efficacy and risk factors for death in patients after heart transplantation. Methods  The clinical data and surgical results of 211 patients who underwent heart transplantation in Beijing Anzhen Hospital, Capital Medical University from March 2001 to December 2017 were collected retrospectively. The other 65 patients who underwent surgery in other hospitals lacked preoperative and intraoperative data, but went to our center for review regularly and the follow-up results were included. All patients were followed-up until December 31, 2019. Kaplan-Meier method was used to calculate the mid- to long-term survival rate, and Cox survival analysis was used to analyze the risk factors affecting the mid- to long-term survival of heart transplant recipients. Results  The length of stay of 211 patients was (35±19)d, and the postoperative length of time was (21±10)d. Sixteen patients died during perioperative period. Fifty-eight patients died during the follow-up period in 260 patients (195 discharged patients in our hospital and 65 patients in other hospitals). The median survival time of 260 recipients was 142 months, the survival rates of 1, 3, 5, 7 and 10 years after operation were 94.7%, 90.6%, 86.8%, 80.4% and 74.1%, respectively. Smoking history, preoperative serum creatinine, aspartate aminotransferase and fasting blood glucose levels were the risk factors affecting the mid- to long-term survival of the recipients (all P＜0.05). Conclusion  Smoking history, preoperative serum creatinine, aspartate aminotransferase and fasting blood glucose levels were the risk factors affecting the mid- to long-term survival of heart transplant recipients in our hospital.