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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 investigate the relationship between the risk factors of posttransplantation diabetes mellitus (PTDM) and the use of calcineurin immunosuppressants. Methods: The age, gender, body mass index (BMI), family history of diabetes mellitus, calcineurin immunosuppressive agents (cyclosporine A, CsA; tacrolimus) were analyzed in 613 allograft cadaver patients after nearly 9 years of operation. Division, FK506) The degree of risk associated with the use of PTDM. Results: The incidence of PTDM was 24.1%. The incidence of PTDM was significantly correlated with patient’s age, family history of diabetes and BMI. The dose-to-effect ratio of calcineurin immunosuppressive drugs in PTDM patients was significantly higher than that in non-diabetic patients (nonPTDM) And after taking FK506 fasting blood glucose higher than taking CsA. CONCLUSION: Compared with patients’ age, family history of diabetes and BMI, taking calcineurin immunosuppressant is the most important risk factor for PTDM, and FK506 is more likely to develop PTDM than CsA.