继发性甲状旁腺功能亢进症患者甲状旁腺组织体外培养的初步探讨  

Preliminary study on in vitro culture of the parathyroid tissue from secondary hyperparathyroidism patients

作　　者：谢亚平[1] 郭瑜琳[1] 张凌[2] 李铎[2] 李文歌[2] 唐功耀[2] 

机构地区：[1]山西医科大学第一医院肾内科,太原030001 [2]中日友好医院肾内科,北京100029

出　　处：《中国血液净化》2012年第7期388-391,共4页Chinese Journal of Blood Purification

基　　金：2010年北京市科委首都临床特色应用研究资助项目(D101100050010025)

摘　　要：目的 通过检测甲状旁腺组织经冰冻保存再复苏后有无分泌功能,为甲状旁腺全切除术后出现持续性低钙血症的患者行再次自体移植提供证据。方法 将因为肾性继发性甲状旁腺功能亢进患者行甲状旁腺切除术,切除的甲状旁腺组织标本进行快速冰冻保存,分别于1个月及3个月后复苏进行体外培养,测定全段甲状旁腺激素(intact parathyroid hormone,iPTH)水平并对组织做形态学检查观察组织的成活情况。结果 共收集甲状旁腺组织标本7例,甲状旁腺组织经形态学及分泌的iPTH检测证实:冻存1月和3月后再复苏的甲状旁腺组织仍有分泌功能,较新鲜甲状旁腺组织分泌功能无差异(F=1.225,P=0.317),且分泌曲线相似,均在5d至10d之间达到高峰;透射电镜观察下可见新鲜甲状旁腺组织的细胞超微结构完整,冻存组织复苏后的甲状旁腺细胞仍具有完整细胞结构。结论 甲状旁腺组织碎片在冻存1月、3月后仍有分泌功能,有用于再移植的可能性。Objective To detect the secretory function of the parathyroid tissue after cryopreservation, in order to provide the possibility of autotransplantation in patients with persistent hypocalcemia after total parathyroidectomy (PTX). Methods Parathyroid tissues were rapidly cryopreserved after isolation from the patients with renal secondary hyperparathyroidism (SHPT). The tissues were thawed after one and three months, and then cultured in vitro to observe the survival of the tissues by morphological examination and intact parathyroid hormone (iPTH) assay. Results We collected parathyroid tissues from seven cases. Parathyroid tissues were confirmed by morphological examination and iPTH assay. The thawed tissues still presented secretory function. There was no difference in secretory function between frozen and fresh tissues (P>0.05). Similar secretory curves with peak at fifth to tenth days were found from frozen and fresh tissues. Transmission electron microscopy showed that integrated cellular ultrastructure was found in fresh parathyroid tissue as well as in recovered parathyroid cells after cryopreservation. Conclusions Secretory function is still presented in thawed parathyroid tissues after being frozen for one to three months, demonstrating the availability of cryopreserved parathyroid tissue for re-transplantation.

关 键 词：继发性甲状旁腺功能亢进症 组织培养 自体移植 甲状旁腺激素 

分 类 号：R69[医药卫生—泌尿科学]