肝移植术后生存期五年及以上患者糖尿病患病率与相关因素分析

摘要

目的 探讨肝移植术后生存期≥5年患者肝移植后糖尿病(PTDM)的患病率及危险因素.方法 收集肝移植术后生存期≥5年的102例患者病历资料进行回顾性分析,分为PTDM组与非PTDM组,比较2组基本参数的差异,采用Logistic多元回归分析进行PTDM的危险因素研究.结果 102例患者PTDM患病率为34.1％ (35/102),移植前糖尿病患病率为17.1％ (17/102),差异有统计学意义(x2=6.102,P＜0.05).PTDM组术前BMI值和肥胖、高血压、糖尿病、高TG者占比均明显高于非PTDM组,组间差异有统计学意义[BMI:(26.2±3.2) kg/m2比(23.3±2.1)kg/m2,肥胖:34.3％(12/35)比11.9％ (8/67),高血压:48.6％ (17/35)比4.5％ (3/67),糖尿病:34.3％(12/35)比7.5％ (5/67),高TG.11.4％ (4/35)比1.5％(1/67),均P＜0.05].Logistic多元回归分析结果显示,PTDM的独立风险因素有:术前BMI[比值比(OR)=1.31,95％置信区间(CI):1.085～1.585,P=0.005]和术前糖尿病(OR=1.49,95％CI=1.33 ～1.66,P=0.000).结论 PTDM患病率高于移植术前糖尿病患病率,其独立的危险因素为术前BMI和术前糖尿病.%Objective To explore the incidence and risk factors of the liver post-transplant diabetes mellitus (PTDM) in patients surviving ≥ 5 years after liver transplantation.Methods Retrospective analysis the data of 102 cases of liver transplantation patient who were divided into PTDM group and non-PTDM group was done.The parameters between the two groups were compared.Study the risk factors of PTDM by Logistic regression analysis.Results The incidence of PTDM was 17.1％ (17/102),the incidence of PTDM was 34.1％ (35/102).The difference was statistically significant (x2 =6.102,P ＜0.05).The P TDM group was statistically different from the non-diabetic group regarding preoperative body mass index (BMI),obesity,hypertension,diabetes,high triglyceride(TG) [BMI:(26.2 ±3.2)kg/m2 vs (23.3 ±2.1)kg/m2,obesity:34.3％ (12/35) vs 11.9％ (8/67),hypertension:48.6％ (17/35) vs 4.5％ (3/67),diabetes:34.3％ (12/35) vs 7.5％ (5/67),high TG:11.4％(4/35) vs 1.5％ (1/67),all P ＜ 0.05].The result of Logistic regression analysis showed that the independent risk factors of the PTDM were preoperative BMI [odds ratio(OR) =1.31,95％ confidence interval (CI):1.085-1.585,P=0.005] and preoperative diabetes (OR=1.49,95％CI:1.33-1.66,P=0.000).Conclusions The incidence of PTDM is higher than the incidence of diabetes before transplantation.The preoperative BMI and preoperative diabetes are independent risk factors.