肾移植术后新发糖尿病危险因素分析  

Analysis of risk factors for new-onset diabetes mellitus after renal transplantation

作　　者：范连慧[1] 刘龙[1] 向军[1] 李昕[1] 曹志强[1] 

机构地区：[1]沈阳军区总医院泌尿外科,110016

出　　处：《器官移植》2011年第5期273-275,279,共4页Organ Transplantation

摘　　要：目的探讨肾移植术后新发糖尿病(new-onset diabetes mellitus after renal transplantation,NODAT)的危险因素。方法术前未患糖尿病接受同种尸体肾移植的患者706例,根据入选时有否NODAT分为NODAT组和非NODAT组。统计NODAT发生率,对两组患者可能存在的NODAT危险因素[糖尿病家族史、年龄、性别、体重指数、透析方式与时间、术后使用含他克莫司(FK506)免疫抑制方案例数、急性排斥反应发生次数]进行组间单因素分析。结果 706例术前非糖尿病的肾移植术后患者中,发生NODAT78例,非NODAT患者628例,NODAT发生率为11%。单因素分析结果显示,NODAT组的患者年龄、术前糖尿病家族史、术后使用含FK506免疫抑制方案例数、急性排斥发生次数,均显著高于非NODAT组(P﹤0.05～P<0.01)。结论患者年龄大、有糖尿病家族史、术后使用含FK506的免疫抑制方案、急性排斥发生次数多是引发NODAT的危险因素。Objective To investigate the risk factors contributing to new-onset diabetes mellitus after renal transplantation （NODAT）. Methods Seven hundred and six nondiabetic patients who underwent ho- mologous cadaver renal transplantation were selected and divided into 2 groups： NODAT group and no NODAT group. The incidence rate of NODAT was calculated. The potential risk factors of NODAT between the two groups were analyzed by single factor analysis, including family history of diabetes, age, sex, body mass index （ BMI）, the dialysis mode and time, cases using tacrolimus （FK506） as immunosuppressive agents after transplantation and frequency of acute rejection. Results Among 706 nondiabetics patients underwent renal transplantation, 78 patients developed NODAT and the other 628 patients didn＇t have NODAT. The incidence rate of NODAT was 11%. The results of single-factor analysis showed that family history of diabetes, age, FK506 administration as immunosuppressive agents after transplantation and frequency of acute rejection in NODAT group were risk factors for NODAT （ P 〈 0. 05-P 〈 0. 01 ）. Conclusions Risk factors of NODAT include older recipients, a positive family history of diabetes, FK506-based immunosuppression regimen as well as high incidence rate of acute rejection.

关 键 词：肾移植 肾移植术后新发糖尿病 危险因素 年龄 家族史 他克莫司 急性排斥反应 

分 类 号：R363.2[医药卫生—病理学]