胰肾联合移植对糖尿病患者胰岛功能的影响

The effect of the pancreas kidney joint transplantation on the pancreas function of the diabetic patient

目的 了解胰肾联合移植术后糖尿病患者胰岛功能的恢复状况及对糖尿病疗效的影响。 方法 检测手术前后血糖、C肽和胰高血糖素 ,并进行比较 ,术后 180 d时测定胰岛素释放试验和葡萄糖耐量试验。 结果 术前病人的 C肽水平明显低于正常 ,胰高血糖素高于正常 ,尽管使用了较大量的胰岛素 ,血糖仍然较高。术后第 1天开始 C肽分泌明显增加 ,几乎超过正常 ;胰高血糖素分泌较术前几乎减少一半 ,30 d后降到正常 ;术后第 7天血糖降到正常 ,第 2 0天停用胰岛素 ,2 40 d内血糖仍然在正常范围 ;术后 180 d时检测葡萄糖耐量试验和胰岛素释放试验结果均正常。 结论 胰肾联合移植既能改善 1型糖尿病肾病病人的肾功能 ,又能通过提高胰腺β细胞的分泌功能 ,达到治疗糖尿病的目的。胰肾联合移植是治疗

Objective To evaluate the recovery of pancreas function and the effects on the diabetic patient after pancreas kidney joint transpantation. Methodes Measuring and comparing the blood sugar, C peptide and glucagon. Performing the insulin releasing test and glucose tolerance test on the 180th day after operation to get acguainted with the recovery of diabetes and the secretion function of β cells. Results Before operation the patient's C peptide level is obviously lower than normal, but the glucagon level is higher than normal. The blood sugar remained at higher level even then larger dose of insulin were applied. On the first day after operation, the C peptide secretion began increased obviously and nearly exceeded normal level; the secretion of glucagon almost decreased to half of the preoperative level, but 30days later, it decreased to normal; the blood sugar decreased to normal on the 7th day after operation. On the 20th day, the application of insulin were stopped, but within 240 days the blood sugar remained in normal range; 180 day after operation, the results of glucose tolerance tests and insulin releasing tests all kept normal. Conclusion The pancreas kidney joint transplantation could improve the kidney function of the patient suffered from type 1 diabetic nephrosis, as well as treat diabetes by enhancing the secretive function of the pancreas β cell. Pancreas kidney joint tranplantation is the best method to cure the nephrosis of latr type 1 diabetes.