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背景:单纯胰腺移植主要适用于病程尚未发展严重并发症的糖尿病患者。建立稳定的大鼠单纯胰腺移植动物模型对移植后免疫耐受和缺血再灌注损伤的研究非常重要。目的:建立大鼠胰肠引流式单纯胰腺移植的动物模型。设计:分组对照动物实验。单位:解放军第四军医大学西京医院胃肠外科。材料:90只SD雄性大鼠(250～320g)。糖尿病大鼠模型采用自阴茎静脉注射脲链霉素65mg/kg,空腹血糖持续2周超过19.4mmol/L为模型成功,58只大鼠静脉注射脲链霉素后,共有22只成功。大鼠分为2组:10只正常大鼠为对照组;22只糖尿病大鼠予单纯胰腺移植,22只正常大鼠为供体。方法:实验于1999-01/2004-07在第四军医大学西京医院胃肠外科实验室进行。单纯胰腺移植组血管吻合采用供胰腺腹主动脉绊(含腹腔动脉及脾动脉)及门静脉绊(含脾静脉)与受体腹主动脉及左肾静脉分别行端侧和端端吻合(袖套式);胰腺断端与小肠行Roux-y式吻合。主要观察指标:于术前2d和术后1,3,7,14,30d监测受体体质量、进食量、饮水量和空腹血糖,并分析失败原因。结果:模型组大鼠22只,正常大鼠10只,均进入结果分析。①大鼠静脉注射脲链霉素后有22只产生了较为严重的糖尿病症状,体质量、饮食量、饮水量及空腹血糖均较正常大鼠增加。②供体平均手术时间为(32.2±12.7)min,受体平均手术时间为(63.4±15.9)min,移植物均无热缺血时间,冷缺血时间为(48.6±18.3)min。除11例于1个月内死亡或胰腺失去功能外,均成活1个月以上。术后并发症主要为继发性胰腺炎和胰漏(7例,31.8%)。成功的单纯胰腺移植后受体第1天血糖即下降(P<0.01),第3天基本达到正常水平;饮水量、进食量、尿量均减少(P<0.01),第14天后基本稳定。结论:该试验方法可以建立相对稳定的动物模型,成功的单纯胰腺移植均可有效地改善糖尿病大鼠内分泌功能。
Background: Simple pancreas transplantation is mainly used in patients with diabetes who have not developed serious complications during the course of their disease. It is very important to establish a stable animal model of pancreas transplantation in rats to study the immune tolerance and ischemia-reperfusion injury after transplantation. OBJECTIVE: To establish an animal model of pancreas drainage in pancreas in rats. Design: group control animal experiment. SETTING: Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University. Materials: 90 SD male rats (250-320 g). Diabetic rat model was intravenously injected with penicillin 65mg / kg, fasting blood glucose for 2 weeks more than 19.4mmol / L for the model was successful, 58 rats intravenous urea streptomycin, a total of 22 successful. Rats were divided into two groups: 10 normal rats as control group; 22 diabetic rats were given simple pancreas transplantation, 22 normal rats as donors. Methods: The experiment was performed at the Gastrointestinal Surgery Laboratory of Xijing Hospital, Fourth Military Medical University from January 1999 to July 2004. Vascular anastomosis in the pancreas transplantation group was performed with anastomosis of the abdominal aorta (including celiac artery and splenic artery) and portal vein stump (including splenic vein) with the abdominal aorta and left renal vein of the recipient Type); pancreatic resection and Roux-y type anastomosis. MAIN OUTCOME MEASURES: Body mass, food intake, water intake and fasting blood glucose were monitored at 2 days before operation and at 1, 3, 7, 14 and 30 days after operation, and the causes of failure were analyzed. Results: Twenty-two rats in model group and 10 rats in normal group were involved in the result analysis. ① After intravenous injection of streptozotocin, 22 rats developed more serious symptoms of diabetes. The body weight, diet, water intake and fasting blood glucose increased more than normal rats. ② The mean operation time of the donor was (32.2 ± 12.7) min and the average operation time of the recipient was (63.4 ± 15.9) min. There was no warm ischemia and the time of cold ischemia was (48.6 ± 18.3) min. Except for 11 cases died within 1 month or the pancreas lost function, all survived for more than 1 month. Postoperative complications were mainly secondary pancreatitis and pancreatic leakage (7 cases, 31.8%). After successful pancreas transplantation, the blood glucose of the recipient decreased on the first day (P <0.01), and reached the normal level on the third day. The water intake, food intake and urine output decreased (P <0.01), and remained stable on the 14th day. Conclusion: This test method can establish a relatively stable animal model. Successful pancreas transplantation can effectively improve the endocrine function of diabetic rats.