摘要
目的 探讨移植胰腺分泌的胰液中肿瘤坏死因子（ＴＮＦα） 水平、淀粉酶流量和受者的血糖水平在排斥反应早期诊断中的意义。方法 采用全胰切除的猪行全胰十二指肠移植， 第１ 组受者不用免疫抑制剂； 第２ 组受者应用甲泼尼龙＋ 雷公藤多甙片； 第３ 组受者应用环孢素Ａ＋ 雷公藤多甙＋ 甲泼尼龙。观察受者的空腹血糖、胰液淀粉酶流量和ＴＮＦα水平。结果 第１ 组受者移植后第４ｄ 胰液和淀粉酶流量下降， 第８ ｄ 停止； 第２ 组受者的胰液和淀粉酶流量在移植后第９ｄ 降为零；第３ 组受者的胰液和淀粉酶流量一直波动在较高水平。第１ 组受者在诊断为排斥反应（血糖升高＞ ７ｍ ｍｏｌ／Ｌ）前３ ｄ 胰液淀粉酶即有明显下降（ 减少８６％ ） ， 而在血糖升高前５ ｄ 胰液ＴＮＦα水平就有明显升高（ 升高约４ 倍） 。结论 移植胰腺发生排斥反应时胰液中ＴＮＦα水平的升高早于胰液淀粉酶流量的改变， 而胰液淀粉酶流量的下降早于血糖改变； 小剂量环孢素Ａ＋ 雷公藤多甙＋ 甲泼尼龙能较好地抑制移植胰腺排斥反应的发生。
Objectives To investigate the implication of TNF α level and amylase in pancreatic juice and recipient blood glucose level in the early diagnosis of acute pancreatic allograft rejection. Methods The total pancreatoduodenal transplantation were successfully performed in total pancreatectomy pigs. In group one no immunosuppression was used; in group 2, the animals were treated with Trimperygium Wilforrdii(TW) and methylprednisolsone(MP); in group 3, the animals were treated with cyclosporine A(CsA), TW and MP.The levels of amylase and TNF α in pancreatic juice and glucose level in blood were determined. Results The pancreatic juice amylase level in the untreated animals was continuously decreased after the 4th posttransplant day. After the eighth day the pancreatic juice output of most grafts stopped. In group 2, pancreatic juice output of most grafts stopped after the 9th posttransplant day. In group 3, pancreatic juice amylase of the grafts remained in a high level. The TNF α level of pancreatic juice in untreated animals was increased markedly at the 4th posttransplant day. The amylase of pancreatic juice was decreased by 86% 3 days before a marked increase of blood glucose was noted. The marked increase of TNF α level in pancreatic juice was noted 5 days before the increase of blood glucose. Conclusions The TNF α level of pancreatic juice was a marker of acute pancreatic allograft rejection earlier than the amylase of pancreatic juice. The increase of blood glucose was the latest marker of pancreas allograft rejection. The triple drug in immunosuppression (CsA, TW and MP) can well prevented the acute pancreas allograft rejection.
出处
《中华器官移植杂志》
CAS
CSCD
2000年第1期44-46,共3页
Chinese Journal of Organ Transplantation
