胰腺乙型肝炎病毒感染及其与糖尿病的关系

目的　确定活体人胰腺组织是否存在乙型肝炎病毒感染 ,并探讨其与糖尿病可能存在的关系。方法　手术获取12例血清HBV标志物呈阳性病人的胰腺组织 ,以原位杂交、免疫组织化学和石蜡切片检测观察。结果　胰腺组织HBVDNA阳性率 8/ 12 ,其中口服葡萄糖耐量试验 (OGTT)异常的 7例检测结果均为阳性 ,OGTT正常的 5例中仅 1例阳性 ,HBVDNA主要位于胰腺和胰岛细胞核内。免疫组化检测胰腺HBsAg阳性率为 10 / 12 ,主要分布在细胞浆。结论　HBV可直接侵害胰腺腺泡和胰岛细胞 ,是造成胰腺功能异常和糖尿病的可能原因。

Relationship between Infection of Hepatitis B Virus in Pancreas and Diabetes Mellitus

Objective To determine whether the hapatitis B virus infection occur in living-body pancreas and its relationship with diabetes mellitus. Method 12 specimens of pancreatic tissue were obtained in patients with positive serum HBV markers. HBV DNA in pancreatic tissue were detected in situ hybridization, by immunohistochemistry and electronic microscopy. Result 8 of 12 pancreatic specimens were positve of HBV DNA. All 7 patients with abnormal oral glucose tolerance test (OGTT) were positive, but only one specimen was positive in patients with normal OGTT. HBV DNA was mainly localized in the mucler of pancreatic acinar and islet cells. The distribution of HBsAg which was detected by immunohistochemical staining was positive in the cytoplasm of pancreatic cells of 10 patients. Conclusion HBV may not only invade the pancreatic acinar and islet cells directly, but also may be a reason of diabetes mellitus complicated by HBV infection.