CAJ | 학술논문

胰岛移植为需终生注射外源性胰岛素的1型糖尿病患者提供了一种新的选择,但移植后排斥反应、终生应用免疫抑制剂及其不良反应仍然限制着胰岛移植的广泛开展.应用Edmonton方案前胰岛移植1年后脱离外源胰岛素的患者仅占8%.Edmonton方案的应用使移植1年后不依赖外源性胰岛素患者的比例达80%(2年后36例接受胰岛移植的受者仅5例不需要胰岛素而且血糖控制良好),该方案是以白细胞介素_2受体单克隆抗体诱导,雷帕霉素、小剂量他克莫司为基础的无激素免疫抑制方案.近来新型免疫抑制剂的出现使胰岛移植的免疫抑制方案更趋安全、有效.本文综述了胰岛移植开展以来免疫抑制剂的应用和进展.
이도이식위수종생주사외원성이도소적1형당뇨병환자제공료일충신적선택,단이식후배척반응、종생응용면역억제제급기불량반응잉연한제착이도이식적엄범개전.응용Edmonton방안전이도이식1년후탈리외원이도소적환자부점8%.Edmonton방안적응용사이식1년후불의뢰외원성이도소환자적비례체80%(2년후36례접수이도이식적수자부5례불수요이도소이차혈당공제량호),해방안시이백세포개소_2수체단극륭항체유도,뢰파매소、소제량타극막사위기출적무격소면역억제방안.근래신형면역억제제적출현사이도이식적면역억제방안경추안전、유효.본문종술료이도이식개전이래면역억제제적응용화진전.
Islet transplantation provides patients with type 1 diabetes mellitus a new choice,which is a substitue for life-long exogenous insulin injection.But immunosuppressants are required after transplantation and side effects of immunosuppresants limit the development of islet transplantation.Before the Edmonton protocol,only 8 percent of the islet recipients got free from insulin injection for the first year.The Edmonton protocol,without glucoeortieoid makes the ratio rise to 80 percent,which is based on rapamycin,low dose tacrolimus and induced by IL-2 receptor monoclonal antibody.Recently,the emergence of some new immunosuppresants make the immunosuppressive protocol safer and more effective.This paper reviews the application and progress of immunosuppresants and immunosuppressive protocol in islet transplantation.