CAJ | 학술논문

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1 a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≥25 kg/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。
목적：료해병탐토소수민족활체신이식술후존활1a이상수자적당뇨병환병정황급상관위험인소。방법대2004년7월-2013년6월접수활체신이식수술적소수민족환자116례진행회고성분석，근거세계위생조직제정적당뇨병진단표준진단시부발생신장이식후당뇨병（PTDM），장환자분성 PTDM조（16례）화 N-PTDM조（100례），대가조절화불가조절위험인소진행단인소분석。결과（1）116례소수민족활체신이식수자중유16례재신이식술후1 a환유신발당뇨병，PTDM적환병솔위13．8％。（2）단인소분석제시량조술전년령、체질지수（BMI）、술전병형간염병독（HCV）감염、술전감유삼지（TG）이상적차이구유통계학의의（P ＜0．05）。량조술전총담고순（TC）이상、술전공복혈당수손、당뇨병가족사、흡연사、을형간염병독（HBV）감염、거세포병독（CMV）감염차이무통계학의의（P ＞0．05）。술후사용배포소A혹FK506、발생급성배척반응、술전년령≥45세、BMI≥25 kg/m2여PTDM명현상관（P ＜0．01）。결론소수민족활체신이식환자적PTDM발생솔교고，응조기예방、조기진단、조기치료，감소당뇨병재신이식환자적발생여발전。
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 >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.