1.兰州大学第一医院内分泌科/甘肃省内分泌疾病临床医学研究中心,兰州 730000
2.中国人民解放军总医院第三医学中心内分泌科,北京 100089
3.锦州医科大学研究生培养基地/中国人民解放军总医院第三医学中心,锦州 121001
Received:17 August 2025,
Revised:2025-10-30,
Accepted:10 November 2025,
Published:28 July 2026
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刘进进,徐春,王宏宇,等.肝移植术后血脂异常患病率特点及危险因素分析:单中心回顾性研究[J].重庆医科大学学报,2026,51(7):934-943.
Liu Jinjin,Xu Chun,Wang Hongyu,et al.Prevalence rate of dyslipidemia after liver transplantation and related risk factors: a single-center retrospective study[J].Journal of Chongqing Medical University,2026,51(7):934-943.
刘进进,徐春,王宏宇,等.肝移植术后血脂异常患病率特点及危险因素分析:单中心回顾性研究[J].重庆医科大学学报,2026,51(7):934-943. DOI: 10.13406/j.cnki.cyxb.004015.
Liu Jinjin,Xu Chun,Wang Hongyu,et al.Prevalence rate of dyslipidemia after liver transplantation and related risk factors: a single-center retrospective study[J].Journal of Chongqing Medical University,2026,51(7):934-943. DOI: 10.13406/j.cnki.cyxb.004015.
目的
2
分析肝移植术后血脂异常患病率及其危险因素。
方法
2
回顾性分析2015年1月至2019年6月于中国人民解放军总医院第三医学中心器官移植科行原位肝移植术受者的临床资料。调查研究人群在肝移植术前及术后1、3、6、12个月血脂4项水平及血脂异常患病率。根据术后12个月血脂水平,分为高甘油三酯(triglyceride,TG)组、TG正常组、高总胆固醇(total cholesterol,TC)组、TC正常组、高低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)组、LDL-C正常组、低高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)组、HDL-C正常组。
结果
2
纳入研究人群305例,其中男246例(80.7%),女59例(19.3%),年龄(51.31±9.35)岁。肝移植术前高TG、高TC、高LDL-C、低HDL-C患病率分别为5.57%、5.25%、3.61%、51.8%;术后12个月分别为40.33%、22.95%、8.52%、20.00%。多因素logistic回归分析显示,女性(
OR
=2.
033,95%CI=1.059~3.902)、空腹血糖(
OR
=1.321,95%CI=1.112~1.570)、血小板计数(
OR
=1.007,95%CI=1.002~1.012)是高TG的独立危险因素(
P
0.05);移植年龄(
OR
=1.047,95%CI=1.008~1.086)、γ-谷氨酰转肽酶(
OR
=1.006,95%CI=1.001~1.011)、血镁(
OR
=36.067,95%CI=1.306~432.974)、血小板计数(
OR
=1.006,95%CI=1.001~1.010)、高血压病史(
OR
=3.036,95%CI=1.325~6.960)是高TC的独立危险因素(
P
0.05);移植年龄(
OR
=1.068,95%CI=1.009~1.131)、γ-谷氨酰转肽酶(
OR
=1.005,95%CI=1.000~1.010)是高LDL-C的独立危险因素(
P
0.05);女性(
OR
=0.150,95%CI=0.033~0.683)、合并肝癌(
OR
=0.351,95%CI=0.176~0.699)、血钙(
OR
=0.036,95%CI=0.001~0.870)是低HDL-C的保护性因素(
P
0.05)。
结论
2
肝移植受者术后3个月血脂水平趋于稳定;肝移植术后血脂异常以高TG、高TC为主,血糖升高、血小板计数增加是高TG的独立危险因素,年龄增加、血镁升高、血小板计数增多是高TC的独立危险因素。
Objective
2
To investigate the prevalence rate of dyslipidemia after liver transplantation and related risk factors.
Methods
2
A retrospective analysis was performed for the clinical data of patients who underwent orthotopic liver transplantation in Department of Organ Transplantation,The Third Medical Center of Chinese PLA General Hospital,from January 2015 to June 2019. The study population was analyzed in terms of the levels of four blood lipid parameters and the prevalence rate of dyslipidemia before liver transplantation and at 1,3,6,and 12 months after surgery. According to the levels of blood lipids at 12 months after surgery,the subjects were divided into high triglyceride(TG) group,normal TG group,high total cholesterol(TC) group,normal TC group,high low-density lipoprotein cholesterol(LDL-C) group,normal LDL-C group,low high-density lipoprotein cholesterol(HDL-C) group,and normal HDL-C group.
Results
2
A total of 305 subjects were included in the study population,a
mong whom there were 246 male patients(80.7%) and 59 female patients(19.3%),with an age of (51.31±9.35) years. The prevalence rates of high TG,high TC,high LDL-C,and low HDL-C were 5.57%,5.25%,3.61%,and 51.8%,respectively,before liver transplantation and were 40.33%,22.95%,8.52%,and 20.00%,respectively,at 12 months after surgery. The multi⁃variate logistic regression analysis showed that female sex(
OR
=2.033,95%CI=1.059-3.902),fasting blood-glucose(
OR
=1.321,95%CI=1.112-1.570),and blood platelet count(
OR
=1.007,95%CI=1.002-1.012) were independent risk factors for high TG(all
P
0.05);age at the time of transplantation(
OR
=1.047,95%CI=1.008-1.086),γ-glutamyl transpeptidase(
OR
=1.006,95%CI=1.001-1.011)],blood magnesium(
OR
=36.067,95%CI=1.306-432.974),blood platelet count(
OR
=1.006,95%CI=1.001-1.011),and a history of hypertension(
OR
=3.036,95%CI=1.325-6.960) were independent risk factors for high TC(all
P
0.05);age at the time of transplantation(
OR
=1.068,95%CI=1.009-1.131) and γ-glutamyl transpeptidase(
OR
=1.005,95%CI=1.000-1.010) were independent risk factors for high LDL-C(all
P
0.05);female sex(
OR
=0.150,95%CI=0.033-0.683),comorbidity with liver cancer(
OR
=0.351,95%CI=0.176-0.699),and blood calcium(
OR
=0.036,95%CI=0.001-0.870) were protective factors for low HDL-C(all
P
0.05).
Conclusion
2
The levels of blood lipids tend to become stable at 3 months after liver transplantation,and high TG and high TC are the main manifestations of dyslipidemia after liver transplantation. Increases in blood glucose and platelet count are independent risk factors for high TG,whereas age,blood magnesium,and platelet count are independent risk factors for high TC.
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