肾移植后糖尿病的研究进展

肾移植后糖尿病可引起移植物排异及败血症,增加移植失败率、死亡率和心血管事件,日益受到人们的关注.肾移植后糖尿病的发病率为2%～50%,高危因素有种族、年龄、性别、遗传、体重、排异反应和免疫抑制剂等.免疫抑制剂作为重要因素参与其发病.大多数患者需要口服降糖药或使用胰岛素治疗.加强移植前后的监测,生活方式干预,减少糖皮质激素的剂量及优化使用免疫抑制剂可预防肾移植后糖尿病的发生.

Recent progress in post-renal transplantation diabetes mellitus

Post-renal transplantation diabetes melltus(FIDM)has grown to be given more attention due to a wide range of complications including rejection,sepsis,higer number of graft loss,increased mortality and cardiovascular events.The incidence is about 2%-50%.Race,age,gender,genetic risk factors,bedyweight,rejection episodes and immunosuppressive drugs have been identified as risk factors for PTDM.Among several risk factors predisposing to PTDM,immunosupprossive drugs play major roles in the pathogenesis.Most patients start on oral antidiabetic drugs and insulin.Prevention strategies include close minitoring before and after transplantation,lifestyle intervention,corticosteroid-sparing regimen and optimization of immunosuppressive therapy.