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中国肝移植受者代谢病管理专家共识(2019版)

中国医师协会器官移植医师分会 中华医学会器官移植学分会肝移植学组

中国医师协会器官移植医师分会, 中华医学会器官移植学分会肝移植学组. 中国肝移植受者代谢病管理专家共识(2019版)[J]. 器官移植, 2020, 11(1): 19-29. doi: 10.3969/j.issn.1674-7445.2020.01.004
引用本文: 中国医师协会器官移植医师分会, 中华医学会器官移植学分会肝移植学组. 中国肝移植受者代谢病管理专家共识(2019版)[J]. 器官移植, 2020, 11(1): 19-29. doi: 10.3969/j.issn.1674-7445.2020.01.004
Branch of Organ Transplant Physician of Chinese Medical Doctor Association, Liver Transplantation Group of Branch of Organ Transplantation of Chinese Medical Association. Expert consensus on the management of metabolic diseases in Chinese liver transplant recipients (2019 edition)[J]. ORGAN TRANSPLANTATION, 2020, 11(1): 19-29. doi: 10.3969/j.issn.1674-7445.2020.01.004
Citation: Branch of Organ Transplant Physician of Chinese Medical Doctor Association, Liver Transplantation Group of Branch of Organ Transplantation of Chinese Medical Association. Expert consensus on the management of metabolic diseases in Chinese liver transplant recipients (2019 edition)[J]. ORGAN TRANSPLANTATION, 2020, 11(1): 19-29. doi: 10.3969/j.issn.1674-7445.2020.01.004

中国肝移植受者代谢病管理专家共识(2019版)

doi: 10.3969/j.issn.1674-7445.2020.01.004
基金项目: 

国家自然科学基金 81570589

国家杰出青年科学基金 81625003

详细信息
    通讯作者:

    徐骁,Email:zjxu@zju.edu.cn

  • 中图分类号: R617, R589

Expert consensus on the management of metabolic diseases in Chinese liver transplant recipients (2019 edition)

More Information
  • 摘要: 为了进一步规范中国肝移植受者代谢病管理,在《中国肝移植受者代谢病管理专家共识(2015版)》基础上,参考近年来国内外相关行业协会发布的诊疗规范和共识,结合我国肝移植临床诊治实践经验,更新为《中国肝移植受者代谢病管理专家共识(2019版)》。此版共识除了介绍糖尿病、高血压病和血脂异常相关内容,还新增高尿酸血症和肥胖症相关内容,旨在更全面地指导肝移植受者代谢病的规范化管理。

     

  • 表  1  免疫抑制剂对肝移植术后代谢病的不良影响

    Table  1.   Adverse effects of immunosuppressive agents on metabolic diseases after liver transplantation

    疾病种类 糖皮质激素 他克莫司 环孢素 mTORi 霉酚酸 抗体类药物(ATG/巴利昔单抗)
    糖尿病 +++ ++ + + - -
    高血压病 ++ ++ ++ - - -
    血脂异常 ++ + ++ +++ - -
    肥胖症 + + + - - -
    高尿酸血症 - ++ ++ - - -
    注:①mTORi为哺乳动物雷帕霉素靶蛋白抑制剂。
    ②ATG为抗胸腺细胞球蛋白。
    下载: 导出CSV

    表  2  肝移植受者代谢病监测

    Table  2.   The monitoring of metabolic diseases in liver transplant recipients

    代谢病 检测指标 控制目标 其他相关检查项目
    糖尿病 空腹血糖、糖化血红蛋白、口服葡萄糖耐量试验 空腹血糖 < 6.7 mmol/L,餐后血糖峰值< 8.88 mmol/L或糖化血红蛋白 < 7% 尿蛋白、眼底镜、颈动脉彩色多普勒超声、冠状动脉CT血管造影
    高血压病 动脉血压 动脉血压 < 130/80 mmHg,肾功能损伤者 < 125/75 mmHg 24 h动态血压、心电图、冠状动脉CT血管造影、尿蛋白、眼底镜
    高脂血症 低密度脂蛋白胆固醇、三酰甘油、总胆固醇 低密度脂蛋白胆固醇 < 100 mg/dL,存在心血管危险因素者 < 70 mg/dL 心电图、颈动脉彩色多普勒超声、冠状动脉CT血管造影
    高尿酸血症 血尿酸 血尿酸 < 360 μmol/L,有痛风发作者 < 300 μmol/L 尿蛋白、血清肌酐、肾小球滤过率、双肾彩色多普勒超声、关节X线或CT、MRI检查
    肥胖症 体质指数 体质指数 < 25 kg/m2 冠状动脉CT血管造影、颈动脉彩色多普勒超声
    下载: 导出CSV
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出版历程
  • 收稿日期:  2019-09-16
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-01-15

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