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肾脏病与透析肾移植杂志 ›› 2015, Vol. 24 ›› Issue (1): 21-25.

• 论文 • 上一篇    下一篇

移植术后糖尿病相关危险因素

  

  • 出版日期:2015-02-28 发布日期:2015-03-07

Post-transplantation diabetes mellitus and the risk factors

  • Online:2015-02-28 Published:2015-03-07

摘要:

摘要 目的:了解我院肾移植患者移植术后新发糖尿病的发病率,及其与国内外其它相关研究对比是否有不同之处。并筛选可能相关的危险因素,为制定移植术后个体化治疗方案提供数据。方法:收集自2007年10月至2011年4月于四川省人民医院器官移植中心行同种异体肾移植手术患者的临床资料,共155人,男性108例,女性47例。根据本研究采用的移植后新生糖尿病诊断标准及定义,共有128例患者纳入本研究,将患者分为2组,PTDM组51名。非PTDM组77名。收集资料包括:患者肾移植术前年龄、体重指数(BMI)、烟酒史、家族史、胆固醇、甘油三酯、血压、尿酸、有无透析治疗、透析时间,术后免疫抑制剂方案和术后急性排异反应发生等。结果:我院肾移植术后糖尿病的发病率为39.84%。两组术前在年龄、性别、BMI、血压、血脂、血尿酸等基础治疗比较无统计学差异(P>0.05)。单因素Logistic回归分析示:1. 患者术前年龄、性别、BMI、血压、血脂、血尿酸等因素与PTDM的发生无相关性(P>0.05);2.是否透析以及透析时间与PTDMD的发生也无相关性(P>0.05);3.FK506免疫方案组及术后发生急性排异反应与PTDM的发生的呈明显相关性(P<0.05)。多因素非条件Logistic逐步回归分析示:将各变量再纳入多因素非条件Logistic逐步回归,显示FK506免疫方案组及术后发生急性排异反应与PTDM的发生的呈明显相关性(P<0.05)。结论:术后使用FK506免疫方案组和术后发生急性排异反应是PTDM发生的独立危险因素。 .术前是否透析和透析时间与PTDM的发生无相关性。

关键词: 肾移植, 移植术后糖尿病, 危险因素

Abstract:

Abstract Objective: To investigate the incidence of renal post-transplantation diabetes mellitus(PTDM)in our hospital, to compare it with other correlated studies domestically and overseas, to screen the related risk factors and to provide data for individual therapy after transplantation. Methodology: One hundred fifty five patients, 108 males and 47 females, were received allogeneic renal transplant surgery from October 2007 to April 2011 in our hospital. Among them, 128 patients who accorded the research criteria were enrolled into this study, and divided into two groups according to whether or not being diagnosed as PTDM. 51 patients were assigned to the group of PTDM and 77 patients were assigned to the group of none-PTDM (N-PTDM).Their clinical data including: age, body mass index (BMI), alcohol and tobacco history, family history, cholesterol, triglyceride, blood pressure, uric acid, whether if dialysis, the dialysis time, postoperative immunosuppressive monitoring and acute rejection, etc .were collected abd compared. Results: The PTDM incidence of post renal transplantation was 39.8% in our hospital. There were no statistical differences between the two groups in age, sex, BMI, blood pressure, blood lipids, blood uric acid and other basic treatment before operation (P > 0.05). Logistic regression analysis of single factor showed that the age, sex, BMI, blood pressure, blood fat , blood uric acid, and other factors had no correlation with PTDM (P>0.05). Whether if dialysis and the dialysis time also hadn’t correlation with PTDM (P>0.05).The immunosuppressive protocols using FK506 primarily and the acute rejection were significantly associated with PTDM (P<0.05). Multi-factors unconditional Logistic stepwise regression analysis also showed that the immunosuppressive protocols using FK506 primarily and the acute rejection were significantly associated with PTDM (P<0.05). Conclusion: The immunosuppressive protocols using FK506 primarily and the acute rejection were independent risk factors of PTDM post renal transplantation.

Key words: Renal transplantation, Post-transplantation diabetes mellitus, Risk factors