自体胰岛细胞移植治疗大鼠全胰十二指肠 切除术后糖尿病的研究

Autologous islet cell transplantation for rats with diabetes mellitus after total pancreaticoduodenectomy

摘要:

目的 探讨全胰十二指肠切除术后大鼠血糖变化及自体胰岛细胞移植治疗术后糖尿病的可行性和 有效性。方法 将SD 大鼠随机分成对照组、手术组和实验组（手术+ 自体胰岛移植），每组10 只大鼠。对照组 未做任何处理；手术组和实验组均行全胰十二指肠切除术；实验组全胰切除后分离、纯化自体胰岛细胞，将胰岛 细胞通过门静脉回植入肝脏。术后各组分别监测血糖、C 肽、糖化血红蛋白，以判断单纯手术后复制模型的有 效性及实验组移植后的胰岛功能。结果 全胰切除后手术组第1 天大鼠血糖即升高为（20.58±2.00）mmol/L ； 手术组与对照组血糖比较，差异有统计学意义（P <0.05），手术组血糖高于对照组；实验组自体胰岛细胞移植后 血糖与手术组比较，差异有统计学意义（P <0.05），实验组血糖下降。术后持续4 个月监测血清糖化血红蛋白，第 4 个月，手术组与对照组比较，差异有统计学意义（P <0.05），手术组升高；实验组与手术组比较，差异有统计 学意义（P <0.05）。结论 全胰十二指肠切除术是复制大鼠糖尿病模型的安全可靠途径；自体胰岛细胞移植是 治疗大鼠全胰切除术后糖尿病的有效方式。

Abstract:

Objective To explore the changes of blood glucose after total pancreaticoduodenectomy and the feasibility and effectiveness of autologous islet cell transplantation in the treatment of postoperative diabetes. Methods SD rats were randomly divided into a control group, an operation group and an experimental group (operation+autologous islet transplantation), each group had 10 rats. The rats of the control group did not have any treatment, while the rats of the operation goup and the experimental group were treated with total pancreaticoduodenectomy. The pancreatic islet cells were isolated and purified from the pancreas after total pancreatectomy. The autologous islet cells were implanted into the liver through the portal vein. Blood glucose, C-peptide and glycosylated hemoglobin were monitored in each group to determine the islet function after transplantation. Results Blood glucose was significantly increased [(20.58 ± 2.00) mmol/L] on the 1st day after total pancreatectomy in the operation group compared with the control group (P < 0.05). After autologous islet cell transplantation, the blood glucose of the experimental group decreased significantly compared to the simple operation group (P < 0.05). Detection of the serum levels of glycosylated hemoglobin 4 months after operation showed that compared with the control group, the serum glycosylated hemoglobin level of the operation group was significantly higher than that of the control group (P < 0.05). There was a significant difference in the serum level of glycosylated hemoglobin between the experimental group and the operation group (P < 0.05). Conclusions Total pancreaticoduodenectomy is a safe and reliable way to establish the rat diabetic model. Autologous islet cell transplantation is an effective way to treat rat diabetes after total pancreatectomy. This experiment provides experimental basis for clinical application.