少数民族活体肾移植受者人群的糖尿病患病情况及相关危险因素分析

An analysis of diabetes prevalence and associated risk factors of the minority Renal Transplant recipients

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 investigate and explore the prevalence of diabetes and related risk factors in the minority Renal Transplant recipients who survived more than a year.Methods 1 1 6 minority patients who were given living donor renal transplantation from July,2004 to June 2013 were retrospectively analyzed and were divided into PTDM group （16 cases）and N-PTDM group （100 cases）according to Post-trans-plantation diabetes mellitus （PTDM）,the diagnostic criteria for diabetes made by World Health Organiza-tion.Single factor analysis was performed with t-test andχ2 test.Results （1 ）1 6 new-onset diabetes oc-curred among the 1 1 6 cases of minority Renal Transplantation,making the prevalence of PTDM of 1 3 .8%. （2）Single factor analysis revealed that preoperative age,body mass index （BMI）,preoperative hepatitis C virus （HCV）infection,preoperative triglyceride （TG）anomalies were statistically significant （P 〈0.05）.There was no significant difference （P ＆gt;0.05）in abnormal preoperative total cholesterol （TC）, preoperative impaired fasting glucose,diabetes family history,smoking history,hepatitis B virus （HBV）infection,cytomegalovirus （CMV）infection,etc.Postoperative use of cyclosporine A or FK506,acute re-jection,preoperative age ≥45 years old,BMI≥25 kg/m2 were significantly associated with PTDM （P 〈0.01）.Conclusion PTDM incidence of minority living donor kidney transplant patients shares the same with that of literature at home and abroad with an exclusion of cadaver donors reported in literatures as an independent risk factor.Early prevention,diagnosis and treatment help reduce the occurrence and develop-ment of the diabetes in patients with renal transplantation.