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中华普通外科学文献(电子版) ›› 2010, Vol. 04 ›› Issue (05) : 434 -437. doi: 10.3877/cma.j.issn.1674-0793.2010.05.009

所属专题: 文献

论著

胰肾联合移植改善糖尿病继发病变的初步研究
邰强1, 何晓顺1,(), 巫林伟1, 鞠卫强1, 朱晓峰1, 马毅1, 王东平1, 胡安斌1, 王国栋1, 胡安1, 黄洁夫1   
  1. 1. 510080 广州,中山大学附属第一医院移植中心
  • 收稿日期:2010-07-15 出版日期:2010-10-01
  • 通信作者: 何晓顺
  • 基金资助:
    卫生部部属医院临床重点项目(2007-2009)

Improvement of secondary complications after simultaneous pancreas-kidney transplantation

Qiang TAI1, Xiao-shun HE1,(), Lin-wei WU1, Wei-qiang JU1, Xiao-feng ZHU1, Yi MA1, Dong-ping WANG1, Anbin HU1, Guo-dong WANG1, An HU1, Jie-fu HUANG1   

  1. 1. Organ Transplantation Center, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
  • Received:2010-07-15 Published:2010-10-01
  • Corresponding author: Xiao-shun HE
  • About author:
    Corresponding author: HE Xiao-shun, Email:
引用本文:

邰强, 何晓顺, 巫林伟, 鞠卫强, 朱晓峰, 马毅, 王东平, 胡安斌, 王国栋, 胡安, 黄洁夫. 胰肾联合移植改善糖尿病继发病变的初步研究[J/OL]. 中华普通外科学文献(电子版), 2010, 04(05): 434-437.

Qiang TAI, Xiao-shun HE, Lin-wei WU, Wei-qiang JU, Xiao-feng ZHU, Yi MA, Dong-ping WANG, Anbin HU, Guo-dong WANG, An HU, Jie-fu HUANG. Improvement of secondary complications after simultaneous pancreas-kidney transplantation[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(05): 434-437.

目的

探讨胰肾联合移植术对糖尿病并发肾功能衰竭患者继发病变的改善情况。

方法

回顾性分析本院糖尿病并发肾功能衰竭患者接受胰肾联合移植术前及术后2年的临床资料。

结果

8例胰肾联合移植患者除1例因脑血管意外放弃治疗外,余7例患者术后恢复顺利。平均随访时间23.3(1~56)个月。与术前比较,尿蛋白明显改善(P<0.05);视网膜病变、心脏功能等指标改善差异无统计学意义。

结论

胰肾联合移植术可改善糖尿病并发肾功能衰竭患者的糖尿病肾病。

To explore the influence of simultaneous pancreas-kidney(SPK) on secondary complications of diabetic recipients with end-stage renal disease.

Methods

A retrospective analysis of pre-and post-SPK data was performed in diabetic patients with end-stage renal disease.

Results

One case died of cerebrovascular accident, 7 cases recovered fluently. After a mean follow-up of 23.3 months, proteinuria decreased significantly, P<0.05, cardiac function and diabetic retinopathy showed no significance.

Conclusions

Simultaneous pancreas-kidney transplantation has a significant improvement on proteinuria in diabetic patients with end-stage renal disease.

表1 8例糖尿病合并肾功能衰竭患者临床资料
1
World Health Organization: Diabetes Mellitus: Report of a WHO Study Group. Geneva, World Health Org, 1985 (Tech.Rep. Ser no. 727).
2
Gaber AO,El-Gebely S,Sugathan P, et al. Early improvement in cardiac function occurs for pancreas-kidney but not diabetic kidney-alone transplant recipients. Transplantation, 1995, 59(8): 1105-1112.
3
Barbosa J,Steffes MW,Sutherland DE, et al. Effects of glycemic control on early diabetic renal lesions: A 5-year randomized controlled clinical trial of insulin-dependent diabetic kidney transplant recipients. JAMA, 1994, 272(8): 600-606.
4
Gremizzi, C,Vergani, A,Paloschi V, et al. Impact of pancreas transplantation on type 1 diabetes-related complications. Current Opinion in Organ Transplantation, 2010, 15(1): 119-123.
5
Drognitz O,Benz S,Pfeffer F, et al. Long-term follow-up of 78 simultaneous pancreas-kidney transplants at a single-center Institutionin europe. transplantation, 2004, 78(12): 1802-1808.
6
2004 Annual report of the international pancreas transplant registry.

URL    
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McCullough KP,Keith DS,Meyer KH, et al. Kidney and pancreas transplantation in the united states, 1998-2007: access for patients with diabetes and end-stage renal disease.American Journal of Transplantation, 2009, 9(4): 894-906.
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Kinkhabwala M,Wilkinson A,Danovitch G, et al. The role of whole organ pancreas transplantation in the treatment of type I diabetes. Am J Sur, 1996, 171(5): 516-520.
9
Marsh C,Forg P.The diagnosis and management of urologic complications in nonrenal transplant recipients. Semin Ural,1994,12(3): 233-250.
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Kwiatkowski A,Michalak G,Czerwinski J, et al. Quality of life after simultaneous pancreas kidney transplantation. Transplantation Procee dings, 2005, 37(8): 3558-3559.
11
Carpentier A,Patterson BW,Uffelma KD, et al. The effect of systemic versus portal insulin delivery in pancreas transplantation on insulin action and VLDL metabolism. Diabetes, 2001, 50(6): 1402-1413
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Humar A,Kandaswamy R,Granger D, et al. Decreased surgical risks of pancreas transplantation in the modern era. Ann Surg, 2000, 231(2): 269-275.
13
Fioretto P,Steffes MW,Sutherland DER, et al. Reversal of lesions of diabetic nephropathy after pancreas transplantation. N Engl J Med, 1998, 339(2): 69-75.
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Ramsay RC,Goetz FC,Sutherland DER, et al. Progression of diabetic retinopathy after pancreas transplantation for insulin-dependent diabetes mellitus. N Engl J Med, 1988, 318(4): 208-214.
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Antonetti DA,Barber AJ,Bronson SK,et al.Diabetic retinopathy: seeing beyond glucose-induced microvascular disease. Diabetes, 2006, 55(9): 2401-2411.
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Cheung A TW,Perez RV,Chen P CY. Improvements in diabetic microangiopathy after successful simultaneously pancreas-kidney transplantation: A computer-assisted intravital microscopy study on the conjunctival microcirculation. Transplantion, 1999, 68(7): 927-932.
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