摘要
目的回顾性分析总结术前非终末期器官功能受损的糖尿病对心脏移植受者移植后早期及中期存活的影响。方法2004年6月至2012年7月间单中心完成315例心脏移植，回顾分析住院和随访资料，根据患者移植前是否患有糖尿病将患者分为糖尿病组（47例）和非糖尿病组（268例）。比较分析两组术后早期恢复情况，包括机械通气时间，因并发症需持续。肾脏替代治疗（CRRT）、体外膜肺氧合（ECMO）或主动脉内球囊反搏（IABP）支持治疗的应用率，重症监护病房（ICU）住院时间及住院总时间。绘制Kaplan-Meier生存曲线，比较两组患者术后早期和中期存活率。结果患者年龄为（44．6±13．8）岁，术前糖尿病占15．0%。糖尿病组与非糖尿病组术后机械通气时间，需CRRT、ECMO和IABP支持治疗的应用率，ICU住院时间及住院总时间的差异均无统计学意义（P〉0．05）。平均随访33个月（17-60个月），糖尿病组和非糖尿病组受者术后1个月存活率为97．9％和97．0％；1年存活率分别为93．5％和95．4％；3年存活率分别为86．6％和91．1％；5年存活率分别为72．8％和88．9％；各个时间段存活率的差异均无统计学意义（P〉0．05）结论术前糖尿病占15．0％的心脏移植单中心经验显示，经严格筛选的非终末期器官功能受损的糖尿病患者心脏移植术后早期及中期存活率未受明显影响。
Objective In this retrospectively study, we compared perioperative and mediumterm survival rate of heart transplant （HT） between non-diabetic and diabetic patients, in order to clarify the effect of preoperative diabetes with non-end-organ damage to patients undergoing HT. Methods From June 2004 to July 2012, the HT Center of Fuwai Hospital had completed a total of 315 cases, and the clinical data of all patients and follow-up information were analyzed. 315 patients were divided into diabetic （47 cases） and non-diabetic （268 cases） groups. Clinical characteristic data and perioperative recovery data of two groups were compared. The perioperative recovery data included perioperative duration of mechanical ventilation, perioperative complications required CRRT/ ECMO/ IABP support, ICU length of stay and total hospital stay. The perioperative and medium- term survivals between two groups were also compared by Kaplan-Meier method. Results Among 315 HT patients, with mean age of （44. 6 ± 13.8） years, diabetic patients accounted for 15.0%. Between diabetic and non-diabetic groups, perioperative duration of mechanical ventilation, incidence of perioperative complications required CRRT/ECMO /IABP support, ICU length of stay and total hospital stay had no statistically significant difference （P〉0. 05）. The median follow-up period was 33 months （17-60 months）. Postoperatively, the one-month, one-year, 3-year and 5-year survival rats in diabetic and non-diabetic groups 97. 9% vs. 97.0%, 93.5% vs. 95.4%, 86. 6% vs. 91.1%, and 72. 8% vs. 88. 9%, respectively. There was no statistically significant difference in the survival between two groups at each time （P〉0. 05）. Conclusion Among 315 HT patients, preoperative diabetic patients accounted for 15.0o//0. The perioperative and medium-term survivals were not affected in HT diabetes patients with non-end-organ damage and restrictive glycemic control.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2013年第3期144-147,共4页
Chinese Journal of Organ Transplantation
基金
基金项目：国家高技术研究发展计划（863计划）课题（2012AA021009）
关键词
心脏移植
糖尿病
2型
存活率
Heart transplantation
Diabetes mellitus, type 2
Survival rate
