摘要
目的探讨肾移植术后新发糖尿病（NODAT）的影响因素以及动脉僵硬度与移植术后新发糖尿病之间的相关性。方法195例肾移植患者，根据糖耐量检查的结果分为NODAT与非NODAT两组。应用动脉硬化检测仪检测患者的肱-踝脉搏波传导速度（baPWV）、踝肘血压指数（ABPI）以及颈动脉内膜中层厚度（IMT），同时对入选对象进行血清学检测，根据动脉僵硬度指标分析两组之间的差异。结果29例移植术后诊断为NODAT，与非NODAT患者相比，移植术前的空腹血糖（FPG）、血压以及丙型肝炎病毒（HCV）感染率都处于一个相当高的水平。多变量回归分析提示，术前HCV感染率、FPG水平以及收缩压是关系到NODAT发生的危险因素。NODAT患者的baPWV明显快于非NODAT患者，同时高血压、年龄以及术后糖化血红蛋白是动脉僵硬度进展的独立决定性因素。结论肾移植术前高水平的FPG、HCV感染以及持续的高血压状态是引起NODAT的危险因素；高血压、年龄偏大以及糖化血红蛋白升高对动脉僵硬度的进展具有重要影响。
Objective To investigate the risk factor for new-onset diabetes after transplantation （NODAT） and the relationship between NODAT and arterial stiffness. Methods Oral glucose tolerance test （OGTT） was performed on 195 patients with renal transplantation. The degree of arterial stiffness, which was determined by brachial ankle pulse wave velocity （baPWV）, ankle- brachial blood pressure index （ABPI） and intima-media thickness （IMT） of the carotid artery, was evaluated. Results Twenty nine patients diagnosed as NODAT had significantly higher fasting plasma glucose before transplantation, blood pressure and incidence of hepatitis C virus （HCV） infection than in patients without NODAT. Multivariate regression analysis revealed that the risk factor of NODAT was fasting plasma glucose pre-transplantation, HCV infection and systolic blood pressure. The independent determinant of the advanced arterial stiffness on NODAT was the statement of hypertension and age. Conclusions High fasting plasma glucose prior to transplantation, HCV infection and high blood pressure are risk factors for NODAT in patients after renal transplantation. Strict control of blood pressure is the key way to prevent the NODAT and atherosclerosis.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2009年第7期415-418,共4页
Chinese Journal of Organ Transplantation
关键词
糖尿病
肾移植
动脉硬化
Diabetes mellitus
Kidney transplantation
Arteriosclerosis
