肝移植术后糖尿病危险因素的分析

目的探讨肝移植术后糖尿病(PTDM)发生及发展的危险因素。方法回顾我院2005年1月至2006年12月间收治的66例肝移植受者的临床资料,对可能导致肝移植术后糖尿病的相关因素进行分析,筛选出在临床出现的高危因素。结果本组PTDM发生率为36%(24/66),多因素Logistic回归分析显示:术中腹水量、术中激素剂量、术后葡萄糖补充量、免疫抑制剂血药浓度、术后30 d内感染是肝移植术后发生糖尿病的高危因素。结论移植术后糖尿病是肝移植常见并发症之一,针对以上危险因素及早采取有效、合理的防治措施是减少PTDM的关键。

Risk factors of diabetes mellitus following liver transplantation

Objective To study the risk factors of post-transplantant diabetes mellitus(PTDM) following orthotopic liver transplantation(OLT). Methods The sixty-six consecutive OLTs performed from January 2005 to December 2006 were recruited in the study.Their preoperative,operative and postoperative variables were retrospectively evaluated using multivariate logistic regression model to identify the significant risk factors. Results Out of the 66 OLTs,24(36%) developed PTDM in our department.The risk factors for PTDM included the volume of acsites,dosage of steroid,supplement of glucose postoperatively,the blood drug level of immunosuppressive agent and the infections in 30 days postoperatively.Conclusion PTDM is a major complication following OLTx.Surveillance for the high risk factors and earlier treatment is the key to decreasing the incidence of PTDM.