【摘要】 目的探讨应用胚胎和成人胰岛细胞联合移植,治疗1型糖尿病的经验。方法将纯化后的胰岛收集于室温的移植培养基中,准备移植。在超声引导下经皮经肝穿刺门静脉主干置管,将胰岛悬液输注移植于患者肝窦内。移植后应用免疫抑止剂。定期检测血糖、血清胰岛素水平、C-肽水平、糖化血红蛋白水平。结果移植后患者餐前血糖达到正常水平,波动幅度较移植前下降71.5%。胰岛素用量仅为原来的26.7%~40%,移植后一个月内未出现低血糖。血清C-肽、胰岛素明显回升,糖化血红蛋白下降。结论通过人胚胰岛在体内增殖提供长期胰岛素来源。人胚胰岛免疫源性低,排斥反应较弱,可以减低术后免疫抑止剂用量。人胚胰岛和成人胰岛联合移植治疗1型糖尿病技术上可行,移植后患者体内胰岛素储备明显增加。更多还原

【Abstract】 Objective To explore the effects of combined transplantation of embry islet and adult pancreatic islet in one patient with type Ⅰ diabetes mellitus. Methods Purefied pancreatic islet was collected in culturemedium.The hepatic sinusiod of the patients was transplanted by transfusion of transhepatic portal canalization.The patient was treated with immunosuppressive protocols after islets transplantation. The level of blood glucose, insulin, C-peptide and glycosylated hemoglobin were regularly determined. Results The level of blood glucose of the patient during a predinner become normal after islets transplantation. The extent of blood glucose decreased 71.5% compared with those before islets transplantation. The dose of insulin for the patient was only 26.7% ~40% compared with those before islets transplantation.The patient did not suffer from hypoglycemia. The level of blood insulin and C-peptide of the patient obviously increased and the level of glycosylated hemoglobin decreased. Conclusion The growth of embryo islet and adult pancreatic islet in vivo could provide long-term source of insulin for the patients with diabetes mellitus.The patient with diabetes mellitus had a lower rejection to the embryo islet. The dose of immunosuppressive agents for the patient with diabetes mellitus underwent islets transplantation decreased. Combined transplantation of embryo islet and adult pancreatic islet in the patient with typeⅠ diabetes mellitus was feasible.The insulin reserve of the the patient with diabetes mellitus underwent islets transplantation obviously increased.更多还原