移植后糖尿病与钙调神经蛋白免疫抑制剂使用的危险分析  

Risk Factors Analysis of Post Transplantation Diabetes Mellitus and Application of Calcineurin Inhibitors

作　　者：谢添成[1] 史道华[1,2] 颜鑫滨[2] 

机构地区：[1]福建医科大学福总临床医学院药学科,福建福州350108 [2]南京军区福州总医院药学科,福建福州350025

出　　处：《现代生物医学进展》2010年第7期1302-1304,1276,共4页Progress in Modern Biomedicine

基　　金：南京军区医学科学技术研究"十一五"计划项目(06MA154)

摘　　要：目的:探讨移植后糖尿病(PTDM)的危险因素与钙调神经蛋白免疫抑制剂使用的关系。方法:分析近9年613例同种异体尸体肾移植术后患者年龄、性别、体质量指数(BMI)、糖尿病家族史、钙调神经蛋白免疫抑制剂(环孢霉A,CsA;他克莫司,FK506)使用与PTDM发生的危险程度。结果:PTDM的发生率为24.1%,PTDM发生与患者年龄、糖尿病家族史及BMI明显相关,PTDM患者钙调神经蛋白免疫抑制剂血药浓度剂量比明显高于移植后非糖尿病患者(nonPTDM),且服用FK506后空腹血糖高于服用CsA。结论:与患者年龄、糖尿病家族史、BMI相比,服用钙调神经蛋白免疫抑制剂是导致PTDM发生最重要的危险因素,且FK506较CsA更易发生PTDM。Objective：To analyze risk factors of post transplantation diabetes mellitus（PTDM） and application of calcineurin inhibitors.Methods：613 patients who received cadaveric renal transplantation were enrolled into this study from January 2001 to January 2009.The general information of patients of age,gender,body mass index（BMI）,family history of diabetes mellitus and that of trough concentration and dosage of calcineurin inhibitors（cyclosporine,CsA;tacrolimus,FK506） were collected and analyzed.Results：The incidence of PTDM was about 24.1% in all patients.The patients of PTDM showed the older age,higher BMI,and stronger tendency of family history of diabetes mellitus than that in patients of non-PTDM.Similarly,the ratios of plasma concentration / dose of calcineurin inhibitors were higher in PTDM cases.Furthermore,the level of fast plasma glucose was obviously increased by FK506.Conclusion：This study suggested that application of calcineurin inhibitors is a greater risk factor on PTDM expect of older age,BMI,and family history of diabetes mellitus.Compared to cyclosporine,the incidence of PTDM induced by tacrolimus is higher.

关 键 词：移植后糖尿病 钙调神经蛋白免疫抑制 危险因素 环孢霉A 他克莫司 治疗药物监测 

分 类 号：R699.587.1[医药卫生—泌尿科学]