关键词: 肾移植, 移植后糖尿病, 他克莫司, 环孢素A

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To evaluate the longterm outcomes of conversion from tacrolimus (Tac) to cyclosporine A (CsA) in patients developed posttransplant diabetes mellitus (PTDM) after kidney transplantation.
Ｍｅｔｈｏｄｏｌｏｇｙ：Data of 88 Tactreated kidney transplantation recipients who developed PTDM were analyzed retrospectively.Tac was continued in 40 patients (Tac group) and was converted to CsA in 48 patients (converting group).The patients were followedup for median 81 months.Glycemic control state and adverse events were recorded and the survival condition was analyzed by KaplanMeier model for death and allograft dysfunction.
Ｒｅｓｕｌｔｓ：There was no difference in general condition and baseline data between two groups.The glycemic control rates in patients converting to CsA were significantly better than them continuing Tac in 1 year (698% vs 474%,P=0041),2 years (641% vs 400%,P=0038) and 3 years (588% vs 312%,P=0025),but there was no difference in 5 years (519% vs 308%,P=0119) between two groups.The proportion of patients without hypoglycemic drug in converting group was significantly higher than the Tac group in 1 year,(395% vs 184%,P=0038),2 years (308% vs 114%,P=0042),3 years (235% vs 31%,P=0016) and 5 years (259% vs 0%,P=0005).There was no difference in the incidence of death,kidney failure,acute rejection,infection and cardiovascular disease between the two groups.Survival analysis for death and allograft dysfunction showed that there was no significant difference between the two groups.
Ｃｏｎｃｌｕｓｉｏｎ：Conversion from Tac to CsA in kidney transplantation recipients who developed PTDM could improve the glycemic control,but couldnt improve survival rate of patients or allografts.

Key words: kidney transplantation, post-transplant diabetes mellitus, tacrolimus, cyclosporine A