不同免疫抑制方案对肾移植术后糖尿病发病率的影响

Prevalence of posttransplant diabetes mellitus under different immun osuppressive therapy

为探讨不同免疫抑制方案对肾移植术后糖尿病 (PTDM)发病率的影响 ,根据不同免疫抑制方案把4 2 9例肾移植患者分为三组 ,定期监测患者用药情况、生化指标、环孢素 A(Cs A )浓度、FK50 6 浓度 ,随访时间至少6个月。结果 :PTDM发病率为强的松 +Cs A+硫唑嘌呤 (1组 ) 11.8% ,强的松 +霉酚酸酯 (MMF) +Cs A(2组 )6 .4 % ,强的松 +MMF+FK50 6 (3组 ) 4 .2 % ,三组之间存在显著差异 ,2组排斥反应率和平均激素用量明显低于 1组。认为肾移植术后不同免疫抑制方案下 PTDM的发病率不同 ,小剂量 Cs A或 FK50 6 联合 MMF的免疫抑制方案可以降低

To compare the prevalence of posttransplant diabetes m ellitus(PTD M) under different immunosuppressive regimen , 429 renal transplant recipients w ere randomized to one of our three groups: ① prednisolone+AZA+CsA (n=185), ② prednisolone +MMF+ CsA (n=171), ③ prednisolone +MMF+FK 506 (n=73) Methyl predni solone (500～1000mg/d ) or ATG were applied when acute rejection (AR)occur Fo ll ow up at least six months,the results showed that the incidence of PTDM in three groups was different In first group, the incidence of PTDM was 11 8% , the in cidence was 6 4% and 4 2% in second and third group respectively The ra te of acute rejection in first group was 42 2% while the rate in second group wa s 14 7%, the integral cumulative dosage of corticosteroid in MMF group was lowe r than that of azathione group The prevalence of PTDM under different im m unosuppressive agents is different , MMF can decrease the incidence of PTDM , especially MMF combinating with low dose of FK 506