供体胰腺保存方法的改进  

An innovative preservation method for pancreas

作　　者：董维平[1] 蔡锦全[2] 谭建明[2] 王煜非[1] 王鉴波[1] 彭永德[1] 

机构地区：[1]上海交通大学附属第一人民医院糖尿病研究室,上海200080 [2]南京军区福州总医院肾移植泌尿科

出　　处：《中华细胞与干细胞杂志（电子版）》2011年第1期26-29,共4页Chinese Journal of Cell and Stem Cell（Electronic Edition）

基　　金：国家自然科学基金(30571759);上海市社会发展基金(沪卫科教[2002353]号)

摘　　要：目的探索在胰腺保存液中添加胰蛋白酶抑制剂保护受损供体胰腺的方法。方法按照获取的供体胰腺分为对照组、完整组和破损组。在完整组和破损组的UW液中添加乌司他丁,于胰腺灌注前取保存胰腺的UW液送测淀粉酶浓度,并比较各组的胰岛得率、纯度、活率和胰岛素释放指数。结果对照组的UW液中的淀粉酶含量为(31±21)U,完整组和破损组分别为(37±22)U和(44±16)U。各组间UW液中淀粉酶含量的差异均没有统计学意义(F=0.835,P=0.446);对照组(12例)、完整组(8例)和破损组(6例)的胰岛得率分别是(319921±98496)、(327095±121698)和(295104±76505)IEQ/胰腺;纯度为(66.9±27.7)﹪、(69.6±26.2)﹪和(67.8±25.6)﹪;活率达(95.3±2.0)﹪、(95.8±1.2)﹪和(95.8±1.0)﹪;释放指数为2.98±1.70、3.10±1.40和2.85±0.48;各组间的胰岛得率、纯度、活率和胰岛素释放指数的差异均无统计学意义(F值<1,P>0.05)。结论胰蛋白酶抑制剂能有效地保护受损的供体胰腺,从而扩大了供胰的来源。乌司他丁作为已在临床使用的蛋白酶抑制剂,用于胰岛移植的供胰保存更为安全可靠。Objective To evaluate the efficiency of trypsin inhibitor during islet isolation from damaged pancreas. Methods Pancreases were divided into three groups according to their conditions： the control group （removed together with duodenum）, the integrated group （removed after the complete separation of duodenum and ligation of the main pancreatic duct） and the damaged group （removed after the resection of partial pancreatic head）. Ulinastatin, a trypsin inhibitor, was added into the UW solution in the integrated group and the damaged group. The concentration of amylase in the UW solution of different groups were determined. At the same time, the yield, purity, motility rate and the insulin release index of islet cells were detected and compared. Results There was no statistical difference for the concentration of amylase in the UW solution among the three groups, control group： （31 ± 21） U; integrated group： （37 ± 22）U; damaged group： （44 ± 16） U; P 〉 0.05. Also there were no significant differences for islet yield [（319 921 ± 98 496） IEQ, （327 095 ± 121 698） IEQ and （295 104 ± 76 505） IEQ respectively; P 〉 0.05], purity（66.9 %± 27.7 %, 69.6 % ± 26.2 % and 67.8 %± 25.6 % respectively： P〉 0.05）, motility rate（95.3%± 2.0%, 95.8%± 1.2% and 95.8%~ 1.0% respectively; P 〉 0.05） and the insulin release index of islet cells （2.98 ± 1.70, 3.10 ± 1.40 and 2.85 ± 0.48 respectively; P 〉 0.05） among the 3 groups. Conclusion Ulinastatin, a clinically used protease inhibitor, could effectively protect damaged pancreas and consequently addition of Ulinastatin to the UW solution may make those pancreases from unsuitable donors useful.

关 键 词：胰腺 保存方法 胰蛋白酶抑制剂 

分 类 号：R657.5[医药卫生—外科学]