肝移植术后糖尿病的初步研究

目的 探讨肝移植术后糖尿病的发生规律和对病人的影响。方法 收集2000年7月～2003年1月间35例长期存活的肝移植病人的临床资料，观察移植术后糖尿病(Post Transplantation Diabcte Mellitus，PTDM)与病人年龄、免疫抑制剂、皮质激素用量和原发病之间的关系及PTDM对病人的影响。结果 术后新出现11例糖尿病，术前空腹血糖和年龄对PT-DM的发生无明显影响。FK506(普乐可复)组和CSA(环孢霉素)组的PTDM发生率无明显差别。晚期肝硬化和接受大剂量皮质激素冲击治疗的病人术后PTDM的发生率明显升高。PTDM对病人术后巨细胞病毒(CMV)感染率无明显影响。结论肝移植术后糖尿病的发生与晚期肝硬化和大剂量激素冲击治疗相关，与年龄和术前空腹血糖无关。

THE PRELIMINARY OBSERVATION OF POST LIVER-TRANSPLANTATION DIABETES MELLITUS

Objective To investigate the rules of the occurrence of post liver transplantation Diabete Mellitus (PTDM).Methods Based on the clinical dataof 35 patients from July 2000 to January 2003,the relationship between PTDM and age,immunosuppression,the dose of corticosteroid and primary diseases are analyzed,as wellas the effect of PTDM on patients.Result After liver transplantation,11 cases occured PTDM.Age and fasting blood glucose had no obvious effects on its occurrence.There was also no difference between the patients treated by FK 506 or CSA.But the morbidities of PTDM in the patients treated by large dose steroids and of end stage cirrhosis were higher than other patients.In thisstudy,PTDM had no effect on the occurrence of cytoegalovirus (CMV) infection.Conclusion The occurrence of PTDM is related with end stage cirrhosis and large dose steroids bolus therapy,but the age and fastingblood glucose pre operation have no effecton it.