胰脾联合移植在胰腺移植中的作用  

Effects of combined transplantation of pancreas-spleen on the survival of pancreatic graft in non-inbred rats

作　　者：李占京[1] 韩本立[1] 吴军[1] 

机构地区：[1]第三军医大学附属西南医院肝胆外科中心,重庆400038

出　　处：《第三军医大学学报》2000年第4期372-375,共4页Journal of Third Military Medical University

摘　　要：目的观察胰腺移植后的自然过程 ,了解供脾在延长胰腺移植存活中的作用。方法采用封闭群Wis tar大鼠作供体和受体 ,受体动物在移植前肌注链脲霉素诱导糖尿病发生 ,术后通过非空腹血糖监测胰腺存活 ,定期处死动物切取移植胰 ,观察组织学变化。实验分为2组 :单纯胰腺移植(A组)和胰脾联合移植(B组)。结果非空腹血糖变化 :A组术前及术后2、6、10、14d分别为(25.59±4.50)及(8.10±1.59)、(10.11±2.17)、(19.02±4.66)和(24.46±1.13)mmol/L(n=7);B组术前及术后2、6、10、14、20、28、36、44d分别为(25.30±3.57)及(8.11±1.59)、(7.95±0.99)、(8.12±1.16)和(10.01±1.51)、(11.40±2.61)、(14.26±2.92)、(18.14±6.41)和26.01mmol/L(术后36d内n=7)。胰腺存活时间 :A组为(11.71±1.80)d ,B组为(39.00±2.77)d ,两组相比P<0.01。组织学观察 ,A组第3天表现为淋巴细胞小量游出浸润 ,第7天大量淋巴细胞游出和浸润 ,第12天胰腺自身结构严重破坏 ,第20天广泛纤维化替代 ;B组淋巴细胞游出和浸润缓和 ,胰腺结构损害轻且缓慢。结论胰脾联合移植能明显延长移植胰存活。单纯胰腺移植和胰脾联合移植后 ,移植胰均受到急性排斥反应损害 ,但胰脾联合移植后移植胰的排斥性损害相对较轻。Objective To observe the natural course of pancreatic transplantation and the effect of donor spleen on the prolongation of the survival of pancreatic allograft. Methods Non-inbred Wistar rats were used in the study. About 10 days before the transplantation, the recipient rats received an intramuscular injection of streptozotocin (70 mg/kg) to induce diabetes and were divided into group A in which the rats received a simple transplantation of the pancreas and group B in which the rats were operated on for a combined pancreas and spleen transplantation. Non-fasting samples of blood were examined for glucose level to evaluate the survival of the pancreatic grafts. Results The average survival time of the pancreatic graft was (11.71±1.80) days in group A and (39.00±2.77) days in group B (P< 0.001). It was found with histological examination that the pancreatic graft as completely replaced with fibroblasts on the 20th day after operation in group A and a slight and slow course of the damages of the pancreatic graft was seen in group B. Conclusion Combined transplantatine of pancreas and spleen prolongs significantly the survival of the pancreatic graft. After simple pancreas transplantation or combined pancreas and spleen transplantation, the pancreatic graft will be replaced with fibrous tissue sooner or later and this process of replacement is significantly delayed when a splenic graft exists.

关 键 词：大鼠 胰腺联合 移植 移植免疫 

分 类 号：R657.5[医药卫生—外科学] R392.4[医药卫生—临床医学]