肝移植患者血糖的动态变化及危险因素探讨

目的探讨肝移植患者血糖的动态变化及易诱发肝移植术后糖尿病(PTDM)的危险因素.方法分析83例接受肝移植患者根据术后是否发生糖尿病分为糖尿病组(31例)和非糖尿病组(52例),对2组不同时间点血糖行重复测量资料方差分析.诱发术后糖尿病的危险因素进行单因素、多因素的Logistic回归分析.结果2组患者在手术前后的血糖指标变化差异皆有统计学意义,且2组之间的血糖值差别亦有统计学意义(P＜0.01).多因素Logistic回归分析显示仅术前糖耐量异常与术后糖尿病的相关(P＜0.05).结论肝移植术后不同阶段血糖水平较术前升高,糖尿病组比非糖尿病组升高明显,术前糖耐量异常是诱发PTDM的独立危险因素.

Study on the Blood Sugar Change and the Risk Factors in Live Transplantation

Objective: To study the blood sugar change in patients with orthotopic liver transplantation (OLT) and the risk factors of post transplantation diabetes mellitus (PTDM). Methods: The history data of 83 patients undergoing OLT were retrospectively analyzed and the patients were divided into two groups according whether developing PTDM or not,patients with PTDM (31cases) and those without PTDM (52 cases). These data were proceeded repeated measurement data F-test. The risk factors inducing PTDM were proceeded multiple factors unconditional Logistic Regression analysis. Results: The blood levels of all patients changed significantly between pre and post operation. There was a significant difference in blood level between two groups (P < 0.01). Abnormal glucose tolerance pre-operation was related to PTDM by multiple factors unconditional Logistic Regression analysis (P < 0.05). Conclusion: Blood sugar level of post transplantation patients is higher than that of pre-transplantation patients. A significant increase is shown in PTDM group compared with that in no PTDM group. Preoperative abnormal glucose tolerance is an independent risk factor of PTDM.