摘要
目的 研究成人肺移植患者移植后糖尿病(post-transplant diabetes mellitus,PTDM)的发生情况及其影响因素.方法 采取便利抽样法,回顾性分析浙江省杭州市某三级甲等综合医院肺移植科2020年1月—2022年12月肺移植患者的临床资料.根据PTDM诊断标准,将肺移植患者分为PTDM组与非PTDM组,统计PTDM发生率,采用单因素及多因素Logistic回归方法分析发生PTDM的影响因素.结果 共纳入140例患者,肺移植患者6个月内发生PTDM共54例,发生率为38.57％.单因素分析显示,两组年龄、性别、BMI、吸烟史、术前糖化白蛋白、术前空腹血糖、术后早期血糖、术前肌酐比较,差异具有统计学意义(P＜0.05).Logistic回归分析显示,性别(OR=5.283)、BMI(OR=6.122)、术前糖化白蛋白(OR=1.330)、术后早期血糖(OR=1.444)是其影响因素.结论 男性、BMI≥24.0、术前糖化白蛋白高、术后早期血糖高的肺移植患者发生PTDM的风险更高.临床护理人员可根据影响因素制订相关护理措施,预防PTDM的发生.
Abstract
Objective To investigate the incidence and risk factors of post-transplant diabetes mellitus(PTDM)in adult lung transplant recipients.Methods Conducting a convenience sampling method,we retrospectively analyzed the clinical data of lung transplant recipients from January 2020 to December 2022 at a tertiary A hospital in Hangzhou,Zhejiang Province.According to the PTDM diagnostic criteria,lung transplant recipients are divided into a PTDM group and a non-PTDM group.The incidence rate of PTDM is calculated,and the influencing factors for PTDM occurrence are analyzed using both univariate and multivariate logistic regression methods.Results A total of 140 patients were included in this study,and 54 lung transplant recipients developed PTDM within 6 months,with an incidence of 38.57％.Univariate analysis showed that there were significant differences in age,gender,BMI,smoking history,pre-operative glycated albumin,pre-operative fasting blood glucose,early post-operative blood glucose and pre-operative creatinine between the 2 groups(P＜0.05).Multivariate Logistic analysis showed that gender(OR=5.283),BMI(OR=6.122),pre-operative glycated albumin(OR=1.330),and early post-operative blood glucose(0R=1.444)were the influencing factors.Conclusion Lung transplant recipients who were male,BMI ≥24.0,with high levels of glycated albumin before surgery,and high blood sugar early after surgery had a higher risk of developing PTDM.Clinical nurses can formulate relevant nursing measures according to the influencing factors to prevent the occurrence of PTDM.
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