摘要
Abstract
Objective To investigate risk factors for the development of post-transplant diabetes mellitus(PTDM)in pa-tients undergoing orthotopic liver transplantation.Methods We included 293 patients who underwent orthotopic liver transplan-tation at The Affiliated Hospital of Qingdao University from July 1,2017 to January 31,2023.According to whether PTDM oc-curred,the patients were divided into PTDM group(n=66)and non-PTDM group(n=227).Significantly different clinical para-meters between the two groups were included in a multivariable logistic regression model to determine independent risk factors for PTDM.The impact of PTDM on the survival rate of the patients was analyzed using a Kaplan-Meier survival curve.Results The incidence rate of PTDM among the patients was 22.5％.The PTDM group and non-PTDM group differed significantly in age,the percentage of patients with a history of hypertension,preoperative fasting blood glucose level,preoperative serum total choles-terol level,preoperative serum low-density lipoprotein level,the percentage of patients treated with cyclosporine after surgery,and the percentage of patients treated with anti-rejection regimen C(cyclosporine alone or combined with mycophenolate or sirolimus)or D(mycophenolate or sirolimus alone)after surgery(t=-3.191,U=-5.668--2.559,x2=3.922-5.689,P＜0.05).The multivariable logistic regression analysis showed that age＞46 years,a history of hypertension,preoperative fasting blood glucose level＞6.1 mmol/L,preoperative serum low-density lipoprotein level＞3.12 mmol/L,postoperative use of anti-rejection regimen C(cyclosporine alone or combined with mycophenolate or sirolimus)were independent risk factors for the occurrence of PTDM(P＜0.05).The survival curve showed that the occurrence of PTDM significantly decreased the 5-year survival rate of the patients(P＜0.05).Conclusion Age＞46 years,a history of hypertension,preoperative fasting blood glucose level＞6.1 mmol/L,pre-operative serum low-density lipoprotein level＞3.12 mmol/L,and postoperative anti-rejection treatment with cyclosporine alone or combined with mycophenolate or sirolimus are independent risk factors for adult PTDM.关键词
肝移植/手术后并发症/糖尿病/危险因素Key words
Liver transplantation/Postoperative complications/Diabetes mellitus/Risk factors分类
临床医学
