Prior diabetes mellitus is associated with increased morbidity in cystic fibrosis patients undergoing bilateral lung transplantation: an 'orphan' area? A retrospective case-control study
Prior diabetes mellitus is associated with increased morbidity in cystic fibrosis patients undergoing bilateral lung transplantation: an 'orphan' area? A retrospective case-control study
复制标题
DOI：
10.1111/j.1445-5994.2008.01786.x
复制
发表时间：
2009-06-01
影响因子：
2.1
通讯作者：
Campbell, L. V.
中科院分区：
文献类型：
--
作者：
Bradbury, R. A.;Shirkhedkar, D.;Campbell, L. V.
背景：本研究的目的是确定既往患有糖尿病是否会增加接受双侧序贯单肺移植的囊性纤维化患者的排斥、感染和/或死亡风险。方法：对2003年1月1日至2005年12月31日期间在三级转诊医院连续25例接受双侧序贯单肺移植的囊性纤维化患者进行回顾性调查。 32%的患者在肺移植前诊断出糖尿病，92%的患者入院时随机血糖水平≥11.1 mmol/L，需要胰岛素。与移植前无糖尿病的患者相比，患有既往糖尿病的患者在移植后因感染相关（3.9 vs 1.2，P = 0.01）和推定排斥相关（1.4 vs 0.5，P = 0.04）入院的人数增加。观察期间，8名既往患有糖尿病的患者中有4人死亡，而17名无糖尿病患者则无一死亡（P = 0.0055）。结论：几乎所有囊性纤维化患者在肺移植后都会出现高血糖，但既往有糖尿病的患者因并发症相关入院的情况较多，死亡率较高。
Background:The aim of this study was to determine whether pre-existing diabetes mellitus increases the risk of rejection, infection and/or death in cystic fibrosis patients undergoing bilateral sequential single-lung transplantation.Methods:A retrospective audit of 25 consecutive patients with cystic fibrosis who underwent bilateral sequential single-lung transplantation between 1 January 2003 and 31 December 2005 at a tertiary referral hospital was carried out.Results:Although 32% patients had diabetes diagnosed before lung transplantation, 92% had random blood glucose levels >= 11.1 mmol/L requiring insulin during admission. Patients with pre-existing diabetes had increased infection-related (3.9 vs 1.2, P = 0.01) and putative rejection-related (1.4 vs 0.5, P = 0.04) hospital admissions post-transplantation compared with those without diabetes pre-transplant. During the period of observation, four of eight patients with a prior diagnosis of diabetes died compared with none of 17 patients without prior diabetes (P = 0.0055).Conclusion:Almost all cystic fibrosis patients develop hyperglycaemia after lung transplantation, but patients with prior diabetes have more complication-related admissions to hospital and a higher mortality rate.