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目的研究肾移植术后糖尿病（ＰＴＤＭ）的临床特性及高危因素。方法将５１２例肾移植患者分为２组，其中４８例ＰＴＤＭ患者为糖尿病组，其余４６４例患者为非糖尿病组。定期监测患者体重、用药情况、生化指标、病毒抗体，并用血清学方法及聚合酶链反应（ＰＣＲ）方法检测主要组织相容性抗原（ＨＬＡ）。结果糖尿病组的平均年龄及术后６个月内激素的用量明显高于非糖尿病组。肾移植术后半年内易出现ＰＴＤＭ，且全部ＰＴＤＭ患者为非肥胖型。大部分ＰＴＤＭ出现时血糖值较高，但不易出现酮症酸中毒。ＰＴＤＭ患者ＨＬＡＢ１５的出现率及腺病毒３型ＩｇＭ抗体的阳性率明显升高。结论遗传因素如某些ＨＬＡ抗原及环境因素如激素和环孢素Ａ的用量、肾移植手术的应激反应、某些病毒感染在ＰＴＤＭ的病因中占有重要地位
Objective To study the clinical characteristics and risk factors of posttransplant diabetic (PTDM). Methods 512 renal transplant recipients were divided into two groups, of which 48 patients with PTDM were diabetic and 464 patients were non-diabetic. The body weight, medication status, biochemical indexes and virus antibodies were regularly monitored. Serum histology and polymerase chain reaction (PCR) were used to detect the major histocompatibility antigens (HLA). Results The mean age of diabetic patients and the amount of hormone within 6 months after operation were significantly higher than those in non-diabetic patients. PTDM is prone to occur within six months after renal transplantation, and all PTDM patients are non-obese. The majority of PTDM appears higher blood sugar levels, but not prone to ketoacidosis. The incidence of HLA B15 in patients with PTDM and the positive rate of adenovirus type 3 IgM antibody was significantly increased. Conclusions Genetic factors such as the amount of certain HLA antigens and environmental factors such as hormones and cyclosporine A, stress response to renal transplantation, and certain viral infections play an important role in the etiology of PTDM