肾移植后糖尿病的临床研究

Clinical study of post-transplant diabetes millitus

通过本移植中心肾移植病人发生糖尿病病例的临床研究，发现肾移植后糖尿病的发病率为１．２４％，好发于年龄较大、血环孢素Ａ（ＣｓＡ）浓度较高、肝功能有异常及有糖尿病家族史的受者，其发生与ＣｓＡ的应用有密切关系。临床表现与一般糖尿病相类似，但感染发生率较高（９０％），治疗方法除常规应用胰岛素、降糖药外，应首先停用或减少ＣｓＡ的用量，并积极治疗感染，疗效尚可，治愈率为７０％。

Abstract Ten post-transplant diabetes millitus (PTDM)patients were found in 801 renal transplant recipients between 1977 and 1993 in our centre. The prevence is 1.24%.Those older patients with high blood level of CsA, abnormality of the liver function and family history of diabetes millitus were susceptible to PTDM. Our study also demonstrated the important role of CsA in the pathogenesis. The latter five patients were measured plasma insulin and C-peptide in three different time and we found when CsA was stopped using or PTDM was cured, both of them increased to normal. The clinical manifestration was weight loss,polyuria,polydipsia and so on. But the infection rate was very high (90%). Most of the PTDM patients were controled with oral hypoglycaemic agents, some of them required insulin. It should be emphasized that CsA be stopped at first in the therapy. Our cure rate was 70% and mortality be 20%.