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目的观察肾移植术后应用他克莫司(FK-506)对患者糖代谢的影响。方法按知情同意将107例无糖尿病病史的肾移植患者分为FK-506组(38例),术后应用FK-506;环孢素A(CsA)组(69例),术后应用CsA。对两组患者的血糖和OGTT进行定时、动态监测。比较两组高血糖及肾移植后糖尿病(PTDM)发生率。结果FK-506组11例(28.95%)出现高血糖,其中8例(21.05%)确诊为PTDM;CsA组8例(11.59%)出现高血糖,其中5例(7.25%)确诊为PTDM。FK-506组高血糖发生率显著高于CsA组(P<0.05),但两组PTDM发生率比较,差异无显著性意义(P>0.05)。结论FK-506有高血糖的不良反应,护理时应对血糖进行严密监测以早发现、早治疗。
Objective To observe the effects of tacrolimus (FK-506) on glucose metabolism in patients after kidney transplantation. Methods 107 patients with no history of diabetes were divided into FK-506 group (FK-506 group) and FK-506 group (CsA group, n = 69) according to informed consent. Postoperative CsA was used. Two groups of patients with blood glucose and OGTT timing, dynamic monitoring. The incidence of hyperglycemia and post-renal allograft diabetes mellitus (PTDM) were compared between the two groups. Results Eleven patients (28.95%) in FK-506 group developed hyperglycemia. Eight patients (21.05%) were diagnosed as PTDM. Eight patients (11.59%) in CsA group had hyperglycemia and five patients (7.25%) were diagnosed as PTDM. The incidence of hyperglycemia in FK-506 group was significantly higher than that in CsA group (P <0.05), but there was no significant difference in the incidence of PTDM between the two groups (P> 0.05). Conclusion FK-506 has adverse reactions of hyperglycemia. During the nursing, the blood glucose should be closely monitored for early detection and early treatment.