胎胰组织培养及移植治疗Ⅰ型糖尿病的临床研究

Clinical Study on Fatal Pancreatic Tissue Culture and Transplantation in the Treatment of Diabetes I

本文报告我院建立了人胎胰组织培养方法,并应用短期培养的人胚胎胰岛组织为20例Ⅰ型糖尿病患者施行了胰岛移植。移植部位均为小网膜腔内。移植最长时间26个月,最短时间4个月,总有效率90%。平均胰岛素每日用量比移植前明显减少50%以上,同时空腹血糖等参数明显下降,血清 C 肽值增长2～4倍。移植前后均未服免疫抑制剂,移植物保持良好的功能,未发生排斥现象。

Pancreatic islet transplantation was performed on 20 IDDM patients with fre-quent attacks of severe ketoacidosis using fetal pancreatic islet tissue cultured invitro for a short period of time.During the tissue culture exocrine function was found disappeared quickly butpancreatic islet tissue could be clearly identified. On the second day of culture, theconcentration of insulin was at the peak value, then going down gradually andfinally at a mininum level on the twelfth day, still about 100 times higher than thatof the normal serum. The group of pancreatic islet cells could yet be detected onthe 14th day of culture with PAP staining.All patients but two were successful in the transplantation. The diabetic symp-toms and signs were comparatively improved, microvascular lesions of fundusameliorated in 3 patients. No ketoacidosis was occured. The average amount ofinsulin required for treatment was reduced to 49% of the previous dosage. Meanwhile,the mean fast blood sugar, 24-hour urine sugar. GHb, GSP and glucagon decreasedsignificantly. Serum C-peptide concentration increased significantly. None was trea-ted with immunosuppressive agents before and after islet transplantation. Isletallografts were functioning well without any rejections.