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目的:了解肾移植受者移植术后新发糖尿病(PTDM)的发病率,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依据。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术受者的临床资料,共155例,男性108例、女性47例。根据本研究采用的PTDM诊断标准及定义,共有128例纳入本研究,将其分为PTDM组(51例)和非PTDM组(77例)。收集资料包括:肾移植术前年龄、体质量指数(BMI)、烟酒史、家族史、胆固醇、三酰甘油、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斥反应发生等。结果:我院PTDM的发病率为39.84%。两组患者术前在年龄、性别、BMI、血压、血脂、血尿酸等方面无统计学差异(P>0.05)。单因素Logistic回归分析示: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);是否透析及透析时间与PTDMD的发生也无相关性(P>0.05);FK506免疫方案组及术后发生急性排斥反应与PTDM的发生的呈明显相关性(P<0.05)。将各变量再纳入多因素非条件Logistic逐步回归,显示他克莫司(FK506)免疫方案组及术后发生急性排斥反应与PTDM的发生呈明显相关性(P<0.05)。结论:术前是否透析和透析时间与PTDM的发生无相关性;术后使用FK506免疫方案组和术后发生急性排斥反应则是PTDM发生的独立危险因素。
OBJECTIVE: To understand the incidence of new-onset diabetes (PTDM) after renal transplant recipients and to screen for possible risk factors for the development of post-transplant individualized treatment programs. Methods: Clinical data of recipients of renal allograft from Sichuan Provincial People’s Hospital Organ Transplantation Center from October 2007 to April 2011 were collected. A total of 155 cases were included, 108 males and 47 females. According to the PTDM diagnostic criteria and definitions used in this study, a total of 128 patients were included in the study, which were divided into PTDM group (n = 51) and non-PTDM group (n = 77). Data collected included preoperative kidney transplantation age, body mass index (BMI), alcohol and tobacco history, family history, cholesterol, triglyceride, blood pressure, uric acid, with or without dialysis, dialysis time, postoperative immunosuppressive regimen and surgery After acute rejection occurs. Results: The incidence of PTDM in our hospital was 39.84%. There was no significant difference between the two groups in terms of age, sex, BMI, blood pressure, blood lipid, blood uric acid and so on (P> 0.05). Logistic regression analysis showed that there was no correlation between the preoperative age, sex, BMI, blood pressure, blood lipids, serum uric acid and other factors in the occurrence of PTDM (P> 0.05). There was no correlation between dialysis and dialysis time and the occurrence of PTDMD (P> 0.05). There was a significant correlation between acute rejection and FDM506 immunization and postoperative PTDM (P <0.05). All the variables were further included in the multivariate non-conditional logistic regression. The results showed that there was a significant correlation between the immunosuppressive group and the occurrence of postoperative acute rejection (P <0.05). Conclusions: There is no correlation between preoperative dialysis and dialysis time and the occurrence of PTDM. Postoperative FK506 immunization and postoperative acute rejection are the independent risk factors of PTDM.