胰腺联合肾脏或肝脏移植后长期存活受者胰岛功能及相关代谢的比较研究  

A comparative study of pancreatic endocrine function and related metabolism after long-term survival between the patients with combined kidney-pancreas transplantation vs those with combined en bloc＇ liver- pancreas transplantation

作　　者：朱晓峰[1] 何晓顺[1] 邓斐文[1] 马毅[1] 王东平[1] 胡安斌[1] 王国栋[1] 鞠卫强[1] 巫林伟[1] 邰强[1] 

机构地区：[1]中山大学附属第一医院器官移植科,510080

出　　处：《中华器官移植杂志》2011年第5期264-267,共4页Chinese Journal of Organ Transplantation

基　　金：国家科技支撑计划（2008BA106806）;广东省科技计划（201013031600222）

摘　　要：目的比较门静脉回流的肝胰器官簇移植（LPT）和体静脉回流的胰肾联合移植（KPT）术后受者胰腺内分泌功能及相关代谢。方法将近6年来存活良好、肝肾功能正常并能定期随访的10例LPT和KPT受者纳入研究，其中LPT组4例，KPT组6例，定期检测血清胰岛素，行胰岛素释放试验、空腹血糖及糖耐量试验，测血清C肽、糖化血红蛋白、血甘油三脂以及总胆固醇等指标，并进行比较分析。结果术后6个月胰岛素激发试验中2h胰岛素KPT组较高（P％0．05）；3个月时血清C肽KPT组较高（P〈0．05）；6个月时总胆固醇LPT组略高（P〈0．05）；但上述3项有差异的指标均在正常生理范围。术后6个月内两组检查值在其他时间点均无明显差异（P〉0．05）。结论LPT和KPT术后受者均可获得良好的胰腺内分泌功能、正常的糖代谢及脂肪代谢，术后6个月内未显示LPT获得更好的代谢功能。Objective To compare the effects of combined ＇en bloc＇ liver-pancreas transplantation （LPT） with portal vein drainage and simultaneous combined kidney-pancreas transplantation （KPT） with systemic venous drainage on the pancreatic endocrine function and related metabolism. Methods Four LPT patients and 6 KPT ones with normal hepato-renal function, good quality of life and periodic follow-up received measurement of serum insulin, insulin provocation test, fasting glucose, oral glucose tolerance test, C-peptide, glycated hemoglobin, triglyceride and total cholesterol; and their laboratory test parameters were compared and analyzed. Results In KPT group, 2-h insulin level, C-peptide level and total cholesterol level were significantly higher at 6th month, 3rd and 6th month postoperation （all P 〈0. 05）. But there was no significant difference in other parameters between the two groups at 6th month after operation. Conclusion Either KPT or LPT can achieve excellent endocrine function, carbohydrate and lipid metabolism; and the results show that portal venous drainage does not offer major metabolic advantages within 6 months after operation.

关 键 词：多器官联合移植 胰腺移植 门静脉回流 体静脉回流 胰腺功能 

分 类 号：R657.5[医药卫生—外科学] R657.3[医药卫生—临床医学]