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儿童肝移植术后血糖水平的监测及其影响因素

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目的 探讨肝移植患儿术后血糖水平的影响因素.方法 采用观察性研究设计,动态收集肝移植患儿血常规、肝移植生化、他克莫司药物浓度、空腹血糖及糖化血红蛋白等数据,并进行统计分析.结果 51例肝移植患儿中,男性31例,女性20例;年龄为3~66个月;身高为(69.4±14.1)cm;体重为(8.0±3.8)kg.术后第1天空腹血糖和糖化血红蛋白分别为(6.70±1.85)mmol/L和(4.4±0.4)%,后逐渐降至术前水平.而乳酸在新肝期15 min达到峰值(2.89±0.95)mmol/L.术后第1天,空腹血糖正常组和异常组的身高为62.5(58.5,66.0)cm比67.0(63.0,75.0)cm,体重为5.8(5.1,7.4)kg比7.8(6.4,9.5)kg,差异有统计学意义(P=0.011、0.003);术后第1天及第7天,糖化血红蛋白正常组和异常组的术中是否输血差异有统计学意义,术后第14天,糖化血红蛋白正常组和异常组的白蛋白水平为(41.9±5.97)比(38.59± 4.14)g/L,差异有统计学意义(P均<0.05).结论 肝移植术后第1天空腹血糖及糖化血红蛋白高于正常值,身高、体重、术中输血及术中低白蛋白水平可能是空腹血糖和糖化血红蛋白水平的影响因素.
Post-pediatric liver transplant:blood glucose monitoring and influencing factors analysis
Objective To evaluate postoperative blood glucose dynamics and determinants in pediatric liver transplant patients.Methods In an observational study,dynamic data were collected from pediatric liver transplant recipents,encompassing routine blood tests,liver transplant biochemistry profiles,cyclosporine drug levels,fasting blood glucose,and glycated hemoglobin measurements.Subsequenty,these data underwent comprehensive statistical analysis to elucidate patterns and outcomes.Results A total of 51 pediatric liver transplant recipients were included in this study,including 31 males(60.8%)and 20 females(39.2%).The age range was 3-66 months,with an average of 11.7±14.9 months.The height range was 54-116 cm,with an average of 69.4±14.1 cm.The weight range was 3.8-22.0 kg,with an average of 8.0±3.8 kg.Fasting blood glucose and glycated hemoglobin both reached their peaks on the first day after surgery,with values of 6.70±1.85 mmol/L and 4.4±0.4%,respectively,and gradually returned to preoperative levels.Lactate levels peaked at 15 minutes in the early post-transplant period,and the data was 2.89±0.95mmol/L.On the first day after surgery,there was a statistically significant difference in height(62.5[58.5,66.0]cm VS 67.0[63.0,75.0]cm)and weight(5.8[5.1,7.4]kg VS 7.8[6.4,9.5]kg)between the normal and abnormal groups in terms of fasting blood glucose.On the first and seventh day after surgery,there was a statistically significant difference in intraoperative blood transfusion between the normal and abnormal groups in terms of glycosylated hemoglobin.On the 14th day after surgery,there was a statistically significant difference in albumin levels(41.9±5.97 VS 38.59±4.14 g/L)between the normal and abnormal groups in terms of glycosylated hemoglobin.All p values were less than 0.05.Conclusion Fasting blood glucose levels and glycosylated hemoglobin exceeded normal values on the first day after liver transplantation.And height,weight,transfusion during surgery and hypoalbuminemia may be influencing factors for fasting blood glucose and glycated hemoglobin levels.

liver transplantationblood glucoseinfluencing factorpediatric

陆晔峰、陈国立、富晶晶

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200127 上海交通大学医学院附属仁济医院护理部

200127 上海交通大学医学院附属仁济医院肝脏外科

肝移植 血糖 影响因素 儿童

上海市2023年度科技创新行动计划软科学研究项目

23692108400

2024

肝脏
上海市医学会

肝脏

CSTPCD
影响因子:0.71
ISSN:1008-1704
年,卷(期):2024.29(3)
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