术后胱抑素C与肾移植后糖尿病发病的相关性分析  

Correlation between postoperative cystatin C and the incidence of post-transplantation diabetes mellitus in kidney transplant recipients

作　　者：王乐 高庆 赵莎 张银福 张闪闪 杜瑞妮 高巍[1] WANG Le;GAO Qing;ZHAO Sha;ZHANG Yinfu;ZHANG Shanshan;DU Ruini;GAO Wei(Department of Anesthesiology,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院麻醉手术部,710061

出　　处：《重庆医学》2023年第7期976-980,共5页Chongqing medicine

基　　金：国家自然科学基金面上项目(81971290);陕西省重点研发计划项目(2020SF-136);西安交通大学第一附属医院临床研究中心面上项目(XJTU1AF-2021CRF-012)。

摘　　要：目的探讨术后胱抑素C(CysC)与肾移植后糖尿病(PTDM)发病的相关性。方法收集2018年1-12月符合纳入排除标准肾移植受者(KTR)285例,根据PTDM诊断标准,分为PTDM组19例和非PTDM(NPTDM)组266例,分析2组基础资料及血清中CysC水平,探讨CysC与PTDM发病的相关性。结果与NPTDM组比较,PTDM组患者年龄较大(P=0.001)、有糖尿病(DM)家族病史(P=0.009)及ASA分级Ⅳ级(P=0.022)的比例较高,术后第2天总胆固醇(TC)、空腹血糖(FPG)、镁、CysC较高,肾小球滤过率(GFR)较低,且低镁血症发生率和口服降糖药患者比例较高,差异均有统计学意义(P<0.05)。术后第2天血清中CysC水平在PTDM疾病发展中与FPG和GFR呈负相关(P<0.05),与镁水平呈正相关(P<0.05)。经多因素logistic回归分析,年龄(OR=1.093,P=0.003)和术后第2天CysC(OR=1.719,P=0.025)是PTDM发生的独立预测因素。结论KT术后第2天CysC与PTDM发病有一定的相关性,是PTDM发生的独立预测因素。Objective To investigate correlation between the level of postoperative cystatin C(CysC)and post-transplantation diabetes mellitus(PTDM)after kidney transplantation(KT).Methods A total of 285 kidney transplant recipients(KTR)who met the inclusion and exclusion criteria from January 2018 to December 2018 were selected,of which 19 cases of KTR with PTDM as the PTDM group and 266 cases of KTR as the NPTDM group according to PTDM diagnostic criteria.The basic variables and the level of CysC in serum of the two groups were analyzed to explore the correlation between CysC and the incidence of PTDM.Results Patients were older(P=0.001)and had a higher proportion of family history of diabetes(P=0.009)and gradⅣof ASA classification(P=0.022)in the PTDM group than those in the NPTDM group(P<0.05).Compared with the NPTDM group,patients had the higher levels of postoperative total cholesterol(TC),fasting blood glucose(FPG),magnesium,and CysC,and lower glomerular filtration rate(GFR)at the 2nd day after KT,and higher ratio of hypomagneemia and oral hypoglycemic drugs in the PTDM group,the differences were statistically significant(P<0.05).At the 2nd day after KT,serum CysC level was negatively correlated with FPG and GFR(P<0.05),and positively correlated with magnesium(P<0.05)in the development of PTDM disease.Multivariate logistic regression analysis showed that age(OR=1.093,P=0.003)and CysC(OR=1.719,P=0.025)at the 2nd day after KT were independent predictors for PTDM.Conclusion CysC at the 2nd day after KT has a certain correlation with PTDM,and is an independent predictor of PTDM.

关 键 词：肾移植 肾移植术后糖尿病 胱抑素C 相关性 

分 类 号：R699.2[医药卫生—泌尿科学]