器官移植术后新发糖尿病是实体器官移植后的一个主要并发症，通常导致住院率和死亡率的升高。免疫抑制剂常被认为是导致器官移植术后新发糖尿病的主要因素，包括糖皮质激素、钙调磷酸酶抑制剂等。其中，钙调磷酸酶抑制剂对血糖的影响最大。他克莫司是从链霉菌属中分离出的发酵产物，是一种强效免疫抑制性大环内酯类抗生素，现广泛用于实体器官移植的免疫抑制剂。他克莫司对细胞免疫有选择性抑制作用，主要通过抑制白介素-2的释放，全面抑制T淋巴细胞的作用。通过查阅了大量的国外文献，本文分别从三个方面综述了他克莫司引起高血糖的机制，包括影响β细胞存活和复制、影响胰岛素分泌、影响外周组织的胰岛素利用。%New-onset diabetes (NODAT) is recognized as a complication after solid organ transplantation, which may increase the risk of morbidity and morality. Immunosuppressive agent is the main risk factor for NODAT after organ transplantation, including glucocorticoids, calcineurin inhibitors etc. Among them, calcineurin inhibitors are most strongly associated with NODAT. Tacrolimus is a macrolide immunosuppressants discovered from the fermentation broth of bacteria streptomyces tsukubaensis which is widely used in organ transplantation. Tacrolimus reduces interleukin-2 (IL-2) production by T-cells. In this review, we will provide a detailed discussion describing potential mechanisms involved in diabetogenic properties of tacrolimus, including effects on β-cell survival and replication, insulin secretion and peripheral insulin action.
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