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目的了解并探讨少数民族活体肾移植术后存活1a以上受者的糖尿病患病情况及相关危险因素。方法对2004年7月-2013年6月接受活体肾移植手术的少数民族患者116例进行回顾性分析,根据世界卫生组织制订的糖尿病诊断标准诊断是否发生肾脏移植后糖尿病(PTDM),将患者分成PTDM组(16例)和N-PTDM组(100例),对可调节和不可调节危险因素进行单因素分析。结果 (1)116例少数民族活体肾移植受者中有16例在肾移植术后1a患有新发糖尿病,PTDM的患病率为13.8%。(2)单因素分析提示两组术前年龄、体质指数(BMI)、术前丙型肝炎病毒(HCV)感染、术前甘油三酯(TG)异常的差异具有统计学意义(P<0.05)。两组术前总胆固醇(TC)异常、术前空腹血糖受损、糖尿病家族史、吸烟史、乙型肝炎病毒(HBV)感染、巨细胞病毒(CMV)感染差异无统计学意义(P>0.05)。术后使用环孢素A或FK506、发生急性排斥反应、术前年龄≥45岁、BMI≥25kg/m2与PTDM明显相关(P<0.01)。结论少数民族活体肾移植患者的PTDM发生率较高,应早期预防、早期诊断、早期治疗,减少糖尿病在肾移植患者的发生与发展。
Objective To understand and discuss the prevalence of diabetes mellitus and its related risk factors among survivors over 1a after live transplantation in minority nationality. Methods A retrospective analysis was performed on 116 ethnic minority patients undergoing living kidney transplantations from July 2004 to June 2013. The diagnosis of post-transplant diabetes mellitus (PTDM) was made according to the diagnostic criteria of diabetes developed by the World Health Organization PTDM group (n = 16) and N-PTDM group (n = 100). Univariate analysis was performed on the adjusted and non-adjusted risk factors. Results (1) 16 out of 116 minority live-donor kidney transplant recipients had new-onset diabetes mellitus 1a after kidney transplantation, and the prevalence of PTDM was 13.8%. (2) The univariate analysis showed that the preoperative age, body mass index (BMI), preoperative hepatitis C virus (HCV) infection, preoperative triglyceride (TG) abnormalities had statistical significance (P <0.05) . There was no significant difference in preoperative total cholesterol (TC), preoperative fasting glucose, family history of diabetes, smoking history, hepatitis B virus (HBV) infection and cytomegalovirus (CMV) infection ). Postoperative use of cyclosporine A or FK506, acute rejection occurred, preoperative age ≥ 45 years old, BMI ≥ 25kg / m2 was significantly associated with PTDM (P <0.01). Conclusion The incidence of PTDM in ethnic minority renal transplant recipients is high. Early prevention, early diagnosis and early treatment should be taken to reduce the occurrence and development of diabetes mellitus in renal transplant recipients.