Nankivell B J, Chapman J R, Bovington K J, O'Connell P J, Allen R D
National Pancreas Transplant Unit, University of Sydney, Westmead Hospital, Australia.
Clin Transplant. 1998 Oct;12(5):434-8.
Simultaneous pancreas and kidney transplantation (SPK) is capable of achieving normoglycemia, as assessed by oral glucose tolerance tests (OGTT), in the majority of diabetic recipients with end-stage renal disease. Despite its success over the last decade, standard ranges for OGTT after SPK are not available for comparison between studies and techniques. We examined 327 prospectively performed OGTT, undertaken in insulin-free bladder-drained SPK recipients, between 1 month and 10 yr after transplantation. Ranges of values for glucose, insulin and C-peptide were derived and areas under the time concentration curves calculated. The normal range of 2-h glucose values from SPK recipients was comparable to WHO criteria for the diagnosis of diabetes mellitus in a normal population; however, the fasting glucose fell below these levels. Fasting and area-under-the-curve (AUC) glucose were remarkably stable with time after SPK, although insulin fell with time after pancreas transplantation. These ranges may allow clinical evaluation of the endocrine function in individual SPK recipients, provide standards for comparison between different centers and techniques, and provide targets for islet transplantation.
通过口服葡萄糖耐量试验（OGTT）评估，同期胰肾联合移植（SPK）能够使大多数终末期肾病糖尿病受者实现血糖正常。尽管在过去十年中取得了成功，但SPK术后OGTT的标准范围尚无法用于不同研究和技术之间的比较。我们对327例前瞻性进行的OGTT进行了研究，这些试验是在无胰岛素膀胱引流的SPK受者移植后1个月至10年期间进行的。得出了葡萄糖、胰岛素和C肽的值范围，并计算了时间浓度曲线下的面积。SPK受者2小时血糖值的正常范围与世界卫生组织（WHO）对正常人群糖尿病诊断的标准相当；然而，空腹血糖低于这些水平。SPK术后空腹血糖和曲线下面积（AUC）葡萄糖随时间显著稳定，尽管胰腺移植后胰岛素随时间下降。这些范围可用于临床评估个体SPK受者的内分泌功能，为不同中心和技术之间的比较提供标准，并为胰岛移植提供目标。
