同种异体甲状旁腺组织移植治疗甲状旁腺功能低下的实验研究

Experimental Study of Allograft Parathyroid Tissues Transplantation to Treat Hypoparathroidism

目的探讨甲状旁腺经不同预处理并移植于腹直肌内后甲状旁腺移植物的功能和生存情况。方法成年雄性Wistar大鼠70只作为供体,成年雄性SD大鼠35只作为受体,建立去甲状旁腺模型受体后采用随机数字表法随机分为直接移植组、高氧培养移植组、环孢素A组、60Co照射移植组及综合处理组5组,每只受体接受2只供体的4个甲状旁腺组织块,甲状旁腺移植于大鼠的腹直肌内。观察各组大鼠在甲状旁腺移植前后不同时相血清钙和甲状旁腺激素(PTH)的变化。结果各组在甲状旁腺组织移植后,1周内血清钙和PTH均能达到或接近正常水平,与移植前相比差异均有统计学意义(P<0.01)。各组移植物的存活时间不同,直接移植组的存活时间最短,血清钙和PTH维持正常水平的时间分别为3周和4周。高氧培养移植组、环孢素A组、60Co照射移植组以及综合处理组血清钙及PTH维持在正常或接近正常水平的时间分别为5周和8周、6周和8周、5周和7周以及5周和9周;除高氧培养移植组移植术后9周(血清钙)及60Co照射移植组移植术后8周(PTH)差异无统计学意义外,其余4组的血清钙和PTH水平在移植术后4～9周与直接移植组比较其差异均具有统计学意义(P<0.05),直接移植组较低;高氧培养移植组、CsA组和60Co照射移植组的血清钙和PTH水平在移植术后7～9周低于综合处理组(P<0.05),综合处理组的血清钙和PTH的维持时间较长。结论腹直肌内甲状旁腺移植能维持血钙于正常水平;甲状旁腺移植物或受体经预处理后能延长其存活时间。甲状旁腺组织经培养后再移植是治疗甲状旁腺功能减退症的一条有效途径。

Objective To investigate the function and survival of parathyroid tissue transplanted into the rectus of rat by different pre-treatment.Methods Male,adult Wistar rats（seventy）as donors and adult SD rats（thirty-five）as receptors.Model rats were established by resection of parathyroid and randomly divided into five groups（digital random method）：direct transplantation group,high-oxygen culture group,ciclosporin A（CsA） group,60Co irradiated group,and integrated treatment group.Each receptor received four PTG from two donors and the PTG were transplanted into the rectus of the receptors.Changes in concentration of serum calcium and PTH at different time points before and after parathyroid transplantation in each group recipient rats were observed.Results Serum calcium and PTH could reach or remain normal level after thyroid tissue transplantation in all groups in 1 week after operation,which significantly differed from those of pre-transplanted（P0.01）.The survival time among the five groups were different： the duration for keeping serum calcium and PTH at normal level（only 3 week and 4 weeks）in direct transplantation group was shortest than that in high-oxygen culture group（5 weeks and 8 weeks）,CsA group（6 weeks and 8 weeks）,60Co irradiated group（5 weeks and 7 weeks）,and integrated treatment group（5 weeks and 9 weeks）.Compared with direct transplantation group,the levels of serum calcium and PTH in high-oxygen culture group,CsA group,60Co irradiated group,and integrated treatment group were significantly higher in 4-9 weeks point（P0.05,except high-oxygen culture group in 9 weeks and 60Co irradiated group in 8 weeks after operation had no significant difference）.Compared with integrated treatment group,the levels of serum calcium and PTH in high-oxygen culture group,CsA group,and 60Co irradiated group were significantly lower in 7-9 weeks point（P0.05）. Conclusions PTG tissues transplanted in rectus can maintain serum calcium level at normal range,and measurement on graft or receptors can prolong the survival period of parathyroid graft.Tissue transplantation of parathyroid after culture may provide a potent way to cure hypothyroidism.