免疫抑制剂对合并或不合并移植后糖尿病肾移植患者自测健康的影响

目的:研究环孢素、他克莫司对合并或不合并移植后糖尿病肾移植患者自测健康的影响。方法:根据是否合并有移植后糖尿病和服用的主要免疫抑制剂,将门诊肾移植患者分为合并糖尿病组、不合并糖尿病组、环孢素组、他克莫司组,应用自测健康评定量表(SRHMS)进行调查。结果:合并有移植后糖尿病肾移植患者生理、心理、社会健康比不合并糖尿病组明显偏低,二者有显著性差异(P<0.01);环孢素、他克莫司对合并移植后糖尿病的肾移植患者生理、心理、社会健康的影响无显著性差异;他克莫司对不合并移植后糖尿病的肾移植患者生理健康的身体症状与器官功能维度、心理健康的正向情绪维度方面较环孢素组得分高,二者有显著性差异(P<0.05)。结论:移植后合并糖尿病明显影响肾移植患者的自测健康;对不合并移植后糖尿病肾移植患者,服用他克莫司的比服用环孢素的有更好的生理健康和心理健康。

Effect of Immunosuppressant on Self-rated Health in Kidney Transplantation Patients with or without Post-transplantation Diabetes Mellitus

OBJECTIVE： To study the influence of cyclosporine and tacrolimus on self-rated health in kidney transplantation patients with or without post-transplantation diabetes mellitus （PTDM）. METHODS： Outpatients with kidney transplantation were divided into group with PTDM, group without PTDM, cyclosporine group and tacrolimus group according to mainly used immunosuppressant and patients with or without PTDM. Self-rated Health Measurement Scale （SRHMS） was applied for investigation. RESULTS： The level of physical health, psychological health and social health of kidney transplantation patients with PTDM were markedly lower than patients without PTDM （P〈0.01）. There was no significant difference in effect of tacrolimus and cyclosporine on physical health, psychological health and social health of kidney transplantation patients with PTDM. Tacrolimus group demonstrated significantly higher scores than the cyclosporine group in physical symptom and organic function dimension of physical health and positive emotion dimension of psychological health in kidney transplantation patients without PTDM （P〈0.05）. CONCLUSION： PTDM significantly affected self-rated health in kidney transplantation patients. Effect of tacrolimus on physical health and psychological health in kidney transplantation patients without PTDM is superior to that of cyclosporine.