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| ???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
|---|---|---|
| dc.contributor.advisor | 陳佳慧(Cheryl Chia-Hui Chen, Ph.D.) | |
| dc.contributor.author | Chuan-I Tsao | en |
| dc.contributor.author | 曹傳怡 | zh_TW |
| dc.date.accessioned | 2021-05-13T08:40:20Z | - |
| dc.date.available | 2021-02-26 | |
| dc.date.available | 2021-05-13T08:40:20Z | - |
| dc.date.copyright | 2016-02-26 | |
| dc.date.issued | 2016 | |
| dc.date.submitted | 2016-02-02 | |
| dc.identifier.citation | Al Aly, Z., Abbas, S., Moore, E., Diallo, O., Hauptman, P. J., & Bastani, B. (2005). The natural history of renal function following orthotopic heart transplant. Clinical Transplantation, 19(5), 683-689.
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Impact of the early reduction of cyclosporine on renal function in heart transplant patients: a French randomised controlled trial. Trials, 13(1), 231. Bourge, R. C., Naftel, D. C., Costanzo-Nordin, M. R., Kirklin, J., Young, J. B., Kubo, S. H., . . . Kasper, E. (1993). Pretransplantation risk factors for death after heart transplantation: a multiinstitutional study. Journal of Heart and Lung Transplantation, 12(4), 549-562. Boyer, O., Le Bidois, J., Dechaux, M., Gubler, M.-C., & Niaudet, P. (2005). Improvement of renal function in pediatric heart transplant recipients treated with low-dose calcineurin inhibitor and mycophenolate mofetil. Transplantation, 79(10), 1405-1410. Boyle, J. M., Moualla, S., Arrigain, S., Worley, S., Bakri, M. H., Starling, R. C., . . . Thakar, C. V. (2006). Risks and outcomes of acute kidney injury requiring dialysis after cardiac transplantation. American Journal of Kidney Diseases, 48(5), 787-796. Brisco, M. A., Kimmel, S. E., Coca, S. G., Putt, M. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/4008 | - |
| dc.description.abstract | 心臟移植後腎功能不全的發生，隨著心臟移植成功率增加與存活期的變長，成為一個越來越常見的問題。根據文獻，心臟移植病人的腎功能會隨時間變化，多在術後一年左右發生明顯變化，這種隨時間變化的情形，主要來自手術當時和術後早期的影響。台灣末期腎臟病的發生率和盛行率皆高居世界之冠，對於心臟移植病人腎功能變化之瞭解多來自國外文獻研究，本土性研究僅討論末期腎臟衰竭長期透析，缺乏腎臟功能變化的趨勢與可能影響因素。本研究目的在瞭解本土性心臟移植病人的腎功能變化的趨勢，並分析影響腎功能變化的風險因素。採縱貫性世代研究，於台灣北部某一醫學中心，收集心臟移植病患術後五年內的腎臟功能及相關變項進行分析，同時檢視使用兩組不同免疫抑制藥物方案的病人腎臟功能。研究結果發現，心臟移植病人腎臟功能由移植前到術後三個月有明顯變化，之後的五年間維持穩定；經由羅吉斯回歸多項式分析結果：不同免疫抑制藥物方案的組別、移植時年齡、缺血性心臟病和移植術前腎功能對病人在移植術後五年腎絲球過濾率小於60 Ml/min1.73m2的風險是有顯著統計意義。此為首份針對心臟移植病人腎臟功能變化的本土性研究結果，提供移植醫療團隊能及早評估，針對影響因素篩檢高危險群，提供適當醫療或進行轉介，延緩腎臟功能惡化的進程。 | zh_TW |
| dc.description.abstract | Renal insufficiency after heart transplantation is a frequently observed comorbidity. We sought to describe the renal function over time, to assess the risk factors associated with chronic renal disease (CKD) development . A retrospective study was conducted in National Taiwan University Hospital (NTUH). A total of 422 adult heart transplant recipients were included. The result had shown that an initial steep decay within 3 months after transplant is followed by a less pronounced decline thereafter. The mean follow time was 41.1±22.7 months. The risk factor for the development of GFR <60 ml/min/1.73m2 after heart transplant includes pre-transplant glomerular filtration rate(GFR) value、transplant age、ischemic cardiomyopathy and immunosuppression protocols. | en |
| dc.description.provenance | Made available in DSpace on 2021-05-13T08:40:20Z (GMT). No. of bitstreams: 1 ntu-105-R02426004-1.pdf: 1034342 bytes, checksum: b20957229a763bf687c2207b796f59b8 (MD5) Previous issue date: 2016 | en |
| dc.description.tableofcontents | 致謝 i
中文摘要 ii 英文摘要 iii 第一章 緒論 1 第一節 研究問題及重要性 1 第二節 研究目的 3 第二章 文獻查證 4 第一節 哪些人需要進行心臟移植？ 4 第二節 心臟移植腎功能不全的定義 5 第三節 腎臟功能的評估 7 第四節 心臟移植後腎功能不全的盛行率 10 第五節 心臟移植病人腎功能的變化趨勢 11 第六節 影響移植病人腎功能變化的因素 12 第七節 心臟移植腎功能不全的影響 18 第三章 研究設計 19 第一節 研究架構 19 第二節 研究假設 20 第三節 研究方法 21 第四節 研究對象 22 第五節 研究工具 23 第六節 資料收集 24 第七節 研究變項操作型定義 25 第八節 資料分析與處理 26 第九節 研究倫理 27 第四章 研究結果 28 第一節 研究對象之基本屬性 30 第二節 以血清肌酸酐來看病人腎功能變化 35 第三節 以腎絲球濾過率來看病人腎功能變化 37 第四節 以慢性腎臟病分期來看病人腎功能變化 39 第五節 末期腎臟衰竭 42 第六節 移植後第五年病人腎功能的危險分析 43 第五章 討論 46 第一節 移植病人腎功能變化趨勢 46 第二節 影響腎功能變化的因素 49 第六章 結論與建議 53 第七章 研究限制與未來研究建議 55 參考資料 56 | |
| dc.language.iso | zh-TW | |
| dc.subject | 腎功能不全 | zh_TW |
| dc.subject | 心臟移植 | zh_TW |
| dc.subject | 腎功能變化 | zh_TW |
| dc.subject | 腎臟衰竭 | zh_TW |
| dc.subject | 慢性腎臟病 | zh_TW |
| dc.subject | heart transplantation | en |
| dc.subject | immunosuppression | en |
| dc.subject | renal insufficiency | en |
| dc.title | 心臟移植病人的腎功能變化 | zh_TW |
| dc.title | Changes in renal function after heart transplantation | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 104-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 王水深(Shoei-Shen Wang),周迺寬(Nai-Kuan Chou),蔡孟昆(Meng-kun Tsai) | |
| dc.subject.keyword | 心臟移植,腎功能變化,腎臟衰竭,慢性腎臟病,腎功能不全, | zh_TW |
| dc.subject.keyword | heart transplantation,renal insufficiency,immunosuppression, | en |
| dc.relation.page | 63 | |
| dc.rights.note | 同意授權(全球公開) | |
| dc.date.accepted | 2016-02-02 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| Appears in Collections: | 護理學系所 | |
Files in This Item:
| File | Size | Format | |
|---|---|---|---|
| ntu-105-1.pdf | 1.01 MB | Adobe PDF | View/Open |
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