HLA—DR、DQ基因与肾移植术后糖尿病的相关性的研究

Relationship between HLA-DR, DQ and diabetes meilitus following renal transplantation

目的探讨肾移植术后糖尿病与HLA-DR、DQ基因的相关性。方法28例患者肾移植术后并发糖尿病，术前进行了HLA分型。另以同期进行HLA分型肾移植术后无糖尿病的患者132例作为对照，二者在性别构成比及年龄方面的差异无统计学意义。术后采用环孢素A（CsA）、硫唑嘌呤和泼尼松（Pred），或采用CsA、霉酚酸酯和Pred预防排斥反应。结果HLA-DRB1＊03、DRBI＊02、DQB1＊03与肾移植术后糖尿病呈显著正相关（相对危险度分别为2．16、1．74和1．99，P值均〈0．05）。HLA-DRB3、HLA-DQB1＊06与糖尿病发生呈显著负相关（相对危险度分别为0．59和0．55，P值均〈0．05）。两种免疫抑制方案间糖尿病发病率的差异无统计学意义（P〉0．05）。结论肾移植术后糖尿病的发生与某些HLA基因（糖尿病易感基因）相关。

Objective To investigate the association of post-transplant diabetes mellitus （PTDM） in kidney transplant recipients with HLA-DR, DQ genes. Methods Retrospective analyses on 160 cases of kidney transplant recipients were carried out. There were 28 cases of PTDM and 132 cases of non-PTDM who were HLA-typed before renal transplantation. Compared with non-PTDM, the patients with PTDM had no statistically significant difference in sex and age. Immunosuppression was achieved by triple regimens consisting of cyclosporine, azathioprine and Pred or cyclosporine, mycophenolate mofteil and Pred to prevent GVHD after kidney transplantation. Results HLA-DRB1 ＊ 03, HLA-DRB1 ＊ 02 and HLA-DQB1 ＊ 03 were related to PTDM （RR= 2. 16,P〈0. 01, RR= 1.74, P〈0.05; RR= 1.99, P〈0. 05 respectively） and HLA-DRB3 and HLA-DQB1 ＊ 06 were negatively related to PTDM （RR = 0. 59, P〈0. 05; RR = 0. 55, P〈0.05）. Incidence of diabetes mellitus between two immune maintenances had no statistically significant difference. Conclusion HLA-DR and DQ genes contribute to the occurrence of PTDM in kidney transplant recipients.