课题背景：课题为临床自选课题，无相关基金支持。拟通过文章的发表，为下一步申请北京首都发展基金奠定基础。肾移植成为治疗终末期肾脏疾病的主要手段，课题拟证明肾移植患者心功能改变与移植肾功能改变的相关性。

应用要点：课题结果证实，应用美国BioZ.Com无创血流动力学监测仪监测肾移植患者术前及术后不同时期血流动力学变化，可以对肾移植患者心功能实现实时、可靠、定量、客观的评估，同时心功能正常与否对肾功能也是一个很好的评估手段。

同行评价：文章采用无创血流动力学检测仪对肾移植患者手术前后血流动力学改变进行评估，属方法学研究，有一定创新性。

摘要
目的: 终末期肾功能衰竭患者均存在不同程度血流动力学异常，拟采用无创血流动力学检测仪，检测肾移植术后患者血流动力学改变情况。
方法：①实验对象：采集2006-04/2007-09就诊于解放军总医院第二附属医院移植中心的肾移植患者16例，围手术期移植肾功能都完全恢复正常，术后定期随访。②实验方法及评估：应用美国BioZ.Com无创血流动力学监测仪，测定15种血流动力学参数进行血流动力学定量评估，包括心率、收缩压、舒张压、平均动脉压、心输出量/心脏指数、每搏输出量/每搏指数、速度指数、加速指数、预射血期、收缩时间比率、液体水平及外周血管阻力/阻力指数。
结果：16例肾移植患者全部进入结果分析。伴随着肾移植术后肾功能的改善，患者心率、血压、预射血期、收缩时间比率、外周血管阻力/阻力指数均较术前下降（P < 0.05），心输出量/心脏指数、每搏输出量/每搏指数、速度指数、加速指数较术前提高（P < 0.05），胸腔液体水平（前负荷）下降不明显（P > 0.05）。
结论：肾移植术后随着尿毒症状态的纠正，患者血流动力学得到明显改善。
关键词：肾移植；肾功能衰竭；血液动力学

李晓利，王强，武若君，李彬，王亚真，张俊红.应用无创血流动力学监测仪评估肾移植患者手术前后血流动力学改变[J].中国组织工程研究与临床康复，2008，12(5):845-848 [www.zglckf.com/zglckf/ejournal/upfiles/08-5/5k-845(ps).pdf]

Noninvasive hemodynamics monitor in evaluating hemodynamics changes in patients before and after renal transplantation

Abstract

AIM：Hemodynamics dysfunction is prevalent in end-stage renal disease (ESRD) patients. This study investigated hemodynamics changes after renal transplantation using noninvasive hemodynamics monitor.
METHODS: ①Sixteen patients undergoing renal transplantation in the Transplantation Center, Second Affiliated Hospital of General Hospital of Chinese PLA from April 2006 to September 2007 were selected. The graft renal function of restored perioperatively. The patients were regularly followed up postoperatively. ②The American BioZ.Com Cardiodynamics Monitor was used to evaluate heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), cardiac output/index (CO/CI), stroke volume/index (SV/SI), velocity index (VI), acceleration index (ACI), pre-ejection period (PEP), systolic time ratio (STR), thoracic fluid content (TFC), and systemic vascular resistance/index (SVR/SVRI).
RESULTS: Sixteen patients were all included in the final analysis. With the improvement of graft renal function, HR, SBP, DBP, MAP, PEP, STR, SVR/SVRI of patients were significantly decreased compared with those before surgery (P < 0.05); CO/CI, SV/SI, VI and ACI were significantly improved (P < 0.05); TFC also decreased, but was not statistically significant (P > 0.05).
CONCLUSION: With urinemia condition corrected following renal transplantation, hemodynamics dysfunction of the patients is also improved.

Li XL, Wang Q, Wu RJ, Li B, Wang YZ, Zhang JH.Noninvasive hemodynamics monitor in evaluating hemodynamics changes in patients before and after renal transplantation.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(5):845-848(China) [www.zglckf.com/zglckf/ejournal/upfiles/08-5/5k-845(ps).pdf]