门静脉内胰岛移植后肝酶升高的影响因素

Boya Zhang, Jing-Na Zhang, Guang-hui Pei, Jinshan Wang, Yaojuan Liu, Xuejie Ding, Zhiping Wang, Shusen Wang
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摘要

目的通过监测门静脉内胰岛移植前后肝功能变化,探讨肝酶升高的影响因素。方法对16例接受门静脉内胰岛移植的糖尿病患者进行分析。监测胰岛移植术后天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)和总胆红素(TBil)水平。结果16例行门静脉内胰岛移植的糖尿病患者中,11例AST升高,8例ALT升高,其中4例AST升高2.5倍,3例ALT升高超过1.5倍。移植前后TBil水平均在正常范围内。胰岛移植组织体积是导致AST显著升高的主要因素(P<0.05)。胰岛移植后门静脉压力的变化与AST升高有关。结论门静脉内胰岛移植后肝酶升高与移植胰岛组织体积的大小有关。因此,提高胰岛的纯度,减少移植组织的数量,有利于预防胰岛移植后的肝损伤。同时,应尽可能缓慢地注入纯化的胰岛,以保持稳定的门静脉压力。关键词:胰岛移植;糖尿病;转氨酶
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Effect factors of liver enzymes elevation afterintraportal islet transplantation
Objective To investigate the effect factors of liver enzymes elevation by monitoring the liver function changes before and after intraportal islet transplantation. Methods 16 diabetic patients who received intraportal islet transplantation in our hospital were analyzed. The levels of aspartic aminotransferase (AST), alanine aminotransferase (ALT)and total bilirubin (TBil)were monitored after islet transplantation. Results Among those 16 diabetic patients who received intraportal islet transplantation, 11 patients showed an increased AST and 8 patients showed an increased ALT, among which a 2.5-fold increase in AST was observed in 4 patients and over 1.5-fold elevation of ALT was observed in 3 patients. The level of TBil were in the normal range before and after transplantation in all patients. Transplanted tissue volume of islet was the main factor for significantly increased AST (P<0.05) in this study. It is also shown that the change in portal pressure is related to the AST elevation after islet transplantation. Conclusions The amount of transplanted islet tissue volume is related to the liver enzymes elevation after intraportal islet transplantation. Therefore, the improvement of the purity of islet to reduce the amount of transplanted tissue could be benefit to prevent the liver injury after islet transplantation. Meanwhile, the purified islets should be injected as slowly as possible to maintain a stable portal pressure. Key words: Islet transplantation; Diabetes mellitus; Transaminase
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