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目的:探讨肾移植术后糖尿病(post-transplantation diabetes mellitus,PTDM)的发病率及危险因素。方法:567例术前无糖尿病的肾移植患者入组,回顾性调查患者性别、移植时年龄、体重、体重指数(BMI)、透析时间、移植前空腹血糖等一般临床资料及移植后1,3,6,12,24个月的免疫抑制方案、空腹血糖等实验室检测结果。根据美国糖尿病协会的诊断标准将患者分为PTDM组和对照组(移植后非糖尿病组),采用t检验和χ~2检验统计两组间上述各变量的差异,采用logistic回归分析发生PTDM的危险因素。结果:PTDM发病率为24.2%(137/567),男性(OR=1.813,P=0.009)、移植时年龄>45岁(OR=2.528,P<0.001)、移植时体重>65 kg(OR=2.445,P<0.001)、移植时BMI>24 kg·m~(-2)(OR=1.819,P=0.005)、术后1,3,6,12,24个月的环孢素日剂量及血浓度均与PTDM的发生显著相关。结论:男性、移植时年龄>45岁、体重>65kg、BMI>24及较高的环孢素日剂量和血浓度是发生PTDM的危险因素。
Objective: To investigate the incidence and risk factors of post-transplantation diabetes mellitus (PTDM). Methods: 567 preoperative non-diabetic renal transplant recipients were enrolled in the study. The clinical data including sex, age at transplant, body weight, body mass index (BMI), dialysis time, fasting blood glucose before transplantation, , 6,12,24 months of immunosuppressive programs, fasting blood glucose and other laboratory test results. According to the diagnostic criteria of American Diabetes Association, the patients were divided into PTDM group and control group (non-diabetic group after transplantation) .T-test and χ ~ 2 test were used to calculate the difference of the above two variables. Logistic regression was used to analyze the risk of PTDM factor. Results: The incidence of PTDM was 24.2% (137/567) in males (OR = 1.813, P = 0.009) and 45 years (OR = 2.528, 2.445, P <0.001). The BMI> 24 kg · m -2 (OR = 1.819, P = 0.005) at transplantation and the daily dose of cyclosporine at 1, 3, Blood concentrations were significantly associated with the occurrence of PTDM. CONCLUSIONS: Male, 45 years old at transplant, weighing> 65 kg, BMI> 24 and higher cyclosporine daily doses and blood concentrations are risk factors for PTDM.