人巨细胞病毒活动性感染及术前HBV感染与肝移植术后糖尿病初步研究

A research for post liver-transplantation diabetes mellitus,active human cytomegalovirus infection and preoperative HBV infection

目的研究肝移植术后糖尿病与人巨细胞病毒(HCMV)活动性感染、术前HBV感染的关系。方法回顾性分析75例术前无糖尿病肝移植患者临床资料,观察患者移植术后糖尿病(post transplantation diabetes mellitus,PTDM)的发生、移植术后HCMV活动性感染及术前HBV感染的情况。结果PTDM发生率为17.3%(13/75)。术后HCMV活动性感染组PTDM发生率(23.1%)明显高于无活动性感染组(4.3%)(P【0.05)。术前HBV感染者PTDM发病率较未感染者高(21.1%与5.6%,P】0.05);HBVDNA与术后PTDM的发病无关(P】0.05);术前HBsAg(+)、HBeAg(+)、HBcAb(+)组,HBsAg(+)、HBeAb(+)、HBcAb(+)组,HBsAg(+)、HBcAb(+)组,发生PTDM情况无统计学差异(P】0.05)。结论肝移植术后糖尿病的发生可能与术后HCMV活动性感染有关,与术前HBV感染无关。

Objective To investigate the relationship between post liver-transplantation diabetes mellitus(PTDM) and active human cytomegalovirus(HCMV) infection, preoperative HBV infection,respectively.Methods The clinical data of 85 patients with liver transplantation were collected to analyze the incidence of PTDM,observe the active HCMV infection and preoperative HBV infection.Results The incidence rate of PTDM is 17.3%(13/75).The incidence of PTDM in patients with active HCMV infection after liver transplation (12/52,23.1%)is higher than that in patients without active HCMV infection(1/23,4.3%)(P<0.05).PTDM patients include 12 incidents of preoperative HBV infection(12/57, P>0.05),3 incidents of positive HBVDNA(3/57, P>0.05),2 incidents of positive HBsAg ,HBeAg and HBcAb(2/11, P>0.05), 5 incidents of positive HBsAg,HBeAb and HBcAb(5/24, P>0.05), 5 incidents of positive HBsAg and HBcAb(5/22, P>0.05).Conclusion PTDM may be relate to active HCMV infection after liver transplantation,unrelated to preoperative HBV infection.