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中华移植杂志(电子版) ›› 2022, Vol. 16 ›› Issue (02) : 114 -118. doi: 10.3877/cma.j.issn.1674-3903.2022.02.011

综述

肝移植新肝期高血糖相关发病机制及不良预后研究进展
崔蕾1, 段怡2, 高志峰2,(), 张欢2   
  1. 1. 100084 北京,清华大学临床医学院
    2. 102218 清华大学附属北京清华长庚医院麻醉科
  • 收稿日期:2022-01-13 出版日期:2022-04-25
  • 通信作者: 高志峰
  • 基金资助:
    北京市属医院科研培育计划项目(PX20210905)

Research progress on the mechanism and adverse outcome of hyperglycemia in the neohepatic phase of liver transplantation

Lei Cui1, Yi Duan2, Zhifeng Gao2,(), Huan Zhang2   

  1. 1. School of Clinical Medicine, Tsinghua University, 100084 Beijing, China
    2. Department of Anesthesiology, Beijing Tsinghua Changgung Hospital, 102218 Beijing, China
  • Received:2022-01-13 Published:2022-04-25
  • Corresponding author: Zhifeng Gao
引用本文:

崔蕾, 段怡, 高志峰, 张欢. 肝移植新肝期高血糖相关发病机制及不良预后研究进展[J]. 中华移植杂志(电子版), 2022, 16(02): 114-118.

Lei Cui, Yi Duan, Zhifeng Gao, Huan Zhang. Research progress on the mechanism and adverse outcome of hyperglycemia in the neohepatic phase of liver transplantation[J]. Chinese Journal of Transplantation(Electronic Edition), 2022, 16(02): 114-118.

肝移植新肝期常发生严重高血糖,其危险因素包括受者因素、供肝因素及外源性因素三方面。新肝期高血糖涉及的主要病理机制包括胰岛素抵抗、缺血再灌注损伤、炎症反应和氧化应激等,常导致预后不良。目前尚缺乏对肝移植新肝期高血糖的诊断、处理和预防相关共识。因此明确肝移植新肝期血糖管理目标,制订专项化血糖管理方案,优化术中血糖管理是亟须解决的临床问题。本文根据国内外研究现状对肝移植新肝期高血糖危险因素、病理生理机制和不良预后作一综述。

Severe hyperglycemia often occurs in the neohepatic phase of liver transplantation, and its risk factors include recipient factors, donor liver factors and exogenous factors. The main pathophysiological mechanisms of neohepatic hyperglycemia include insulin resistance, ischemia-reperfusion injury, inflammatory reaction and oxidative stress, which often result in poor prognosis. At present, there is still a lack of consensus on the diagnosis, management and prevention of neohepatic hyperglycemia in liver transplantation. Therefore, it is an urgent clinical problem to clarify glucose management objectives, formulate specific glucose management programs and optimize intraoperative glucose management. This article reviews the risk factors, pathophysiological mechanism and adverse prognosis of neohepatic hyperglycemia in liver transplantation.

图1 肝移植新肝期高血糖主要相关发病机制
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