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目的评估糖尿病患者肾移植的安全性和有效性。方法回顾性分析我中心2008-2012年1 061例肾移植患者的临床资料,根据术前是否患有糖尿病分为糖尿病组(n=116)和非糖尿病组(n=945),分析比较在急性排斥反应(acute rejection,AR)、术后感染、人/肾存活率、不良事件发生情况等方面的差异。结果糖尿病组和非糖尿病组AR发生率分别是20.6%和18.3%,差异无统计学意义(P=0.53);糖尿病组和非糖尿病组术后感染率分别是23.3%和15.6%,差异有统计学意义(P=0.03);两组术后1、2、3年人/肾存活率差异无统计学意义(P>0.05);糖尿病组和非糖尿病组术后不良事件发生率分别是42.2%和32.3%,差异有统计学意义(P=0.03)。结论糖尿病患者术后感染率、不良事件发生率均高于普通患者,但并不影响术后人/肾存活率和急性排斥反应发生率;糖尿病可能会降低肾移植术的安全性,但不影响肾移植术的疗效,糖尿病患者可以在保证安全性的前提下进行肾移植术。
Objective To evaluate the safety and efficacy of renal transplantation in diabetic patients. Methods The clinical data of 1,061 renal transplant recipients from 2008 to 2012 in our center were retrospectively analyzed. According to whether diabetes was preoperatively divided into diabetic group (n = 116) and non-diabetic group (n = 945) Rejection (AR), postoperative infection, the survival rate of human / kidney, the occurrence of adverse events and so on. Results The incidence of AR in diabetic group and non-diabetic group was 20.6% and 18.3%, respectively, with no significant difference (P = 0.53). The postoperative infection rates in diabetic group and non-diabetic group were 23.3% and 15.6%, respectively (P = 0.03). There was no significant difference in the one-year, two-year and three-year survival rate between two groups (P> 0.05). The incidence of postoperative adverse events in diabetic patients and non-diabetic patients was 42.2% And 32.3%, the difference was statistically significant (P = 0.03). Conclusion The incidence of postoperative infection and adverse events in patients with diabetes mellitus are higher than those in normal patients, but it does not affect the postoperative survival rate of human / kidney and the incidence of acute rejection. Diabetes mellitus may reduce the safety of renal transplantation, but it does not affect The efficacy of renal transplantation, diabetic patients can be carried out under the premise of ensuring safety of kidney transplantation.