术前糖尿病对移植肾功能恢复的影响

Effect of preoperative diabetes mellitus on recovery of grafted kidney function

目的分析术前糖尿病对术后移植肾功能恢复的影响。方法回顾性分析我中心2008-2012年1 061例肾移植患者的临床资料,根据术前是否患有糖尿病分为糖尿病组(n=116)和非糖尿病组(n=945),比较两组术后发生移植肾功能延迟恢复(delayed grafted function,DGF)的情况以及移植肾功能恢复时间。结果糖尿病组和非糖尿病组DGF发生率分别是21.6%、14.1%,两组差异有统计学意义(P=0.03);糖尿病组和非糖尿病组移植肾功能恢复时间分别是(21.28±18.95)d和(16.72±14.08)d,两组差异有统计学意义(P=0.04);糖尿病组和非糖尿病组DGF失功比例分别是12%、8.3%,两组差异无统计学意义(P=0.83)。结论术前糖尿病不会增加急性肾小管坏死、药物肾毒性等DGF病因的发生,不会提高移植肾失功的比例;围手术期严格控制血糖可以促进移植肾功能恢复。

Objective To analyze the effect of preoperative diabetes mellitus （DM） on function recovery of grafted kidney. Methods Clinical data about 1061 patients who underwent kidney transplantation in our center from 2008 to 2012 were retrospectively analyzed. The patients were divided into DM group （n=116） and non-DM group （n=945）. The delayed function recovery and the function recovery time of grafted kidney were compared between the two groups. Results The incidence of delayed function recovery of grafted kidney was 21.6% and 14.1%, respectively, in DM group and non-DM group （P=0.03）. The function recovery time of grafted kidney was 21.28 ± 18.95 d and 16.72 ± 14.08 d, respectively, in DM group and non-DM group （P=0.04）. The function loss rate of grafted kidney was 12% and 8.3%, respectively, in DM group and non-DM group （P=0.83）. Conclusion Preoperative DM does not increase the incidence of acute renal tubule necrosis, drug toxicity to kidney, function loss of grafted kidney, and can promote the function recovery of grafted kidney if the blood glucose level is well controlled in peri-operative period.