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糖尿病是一种以血糖水平升高为基本特征的慢性代谢性疾病,是由于内源性的胰岛β细胞总量减少或功能减退,造成的胰岛素分泌量绝对或相对不足所致。近年来,糖尿病发病率逐年升高,已成为威胁人类健康的重大问题[1]。
目前,几乎所有的1型糖尿病和部分胰岛素依赖的2型糖尿病患者均需应用外源性胰岛素注射来控制血糖。但该方法不能根治糖尿病,也不能避免远期并发症的发生,且低血糖晕厥的发生率较高。因此,重建内源性胰岛素分泌系统成为糖尿病治疗的关键。胰腺或胰岛细胞移植可补充患者体内胰岛β细胞数量的不足,重建胰岛β细胞总量的稳态平衡,不仅能有效控制血糖,还可防止或逆转糖尿病并发症,为糖尿病治疗带来了新的希望[2]。
目前胰岛细胞移植后的监测主要通过血糖、C肽、糖化血红蛋白水平以及糖耐量测定等方法,上述方法均为间接反映移植胰岛细胞的存活情况及其功能是否正常[3],对于早期检测移植物的异常比较困难。而作为“金标准”的肝穿刺活检为有创性检查,成功率低,无法满足动态监测的要求[4]。
近年来,分子影像学得到快速发展,它可以实现早期、无创地进行移植的胰岛细胞显像,主要包括光学显像、放射性核素显像、MRI及超声成像等,为胰岛细胞移植的动态监测带来了新的曙光。
胰岛细胞移植监测的分子影像学进展
Research progress of molecular imaging in monitoring islet transplantation
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摘要: 糖尿病已成为危害人类健康的常见病和多发病。胰岛细胞移植为糖尿病治疗带来新的希望。近年来, 分子影像学技术包括光学显像、核素显像、MRI及超声成像等, 可在活体条件下无创地进行移植的胰岛细胞显像, 为胰岛细胞移植监测提供了灵敏及特异的监测方法。特别是近年来胰高血糖素样肽1类似物胰岛细胞显像的成功, 为胰岛细胞移植监测提供了崭新的方法, 显示了良好的应用前景。
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关键词:
- 胰岛移植 /
- 正电子发射断层显像术 /
- 磁共振成像 /
- 超声检查 /
- 生物发光成像
Abstract: Diabetes is significant public health problem. Islet transplantation has been a promising treatment for diabetes. Recently, molecular imaging methods like optical imaging, radionuclide imaging, MRI and US, could monitor islet transplantation in vivo via non-invasive way and provide high sensitive and specific monitoring methods for islet transplantation. Especially in recent years, the success of islet cell imaging with the glucagon like peptide 1 analogue, brings a new method for the monitoring of islet cell transplantation and demonstrates favorable prospect in clinical practice. -
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