亲体肾移植术后早期血、移植肾及皮下组织葡萄糖的相关性研究

目的通过监测亲体肾移植术后早期动脉血、移植肾组织及皮下组织葡萄糖的浓度及变化，寻找三者间的相关性，及早发现术后并发症。方法9例终末期肾病行亲属捐肾肾移植术的患者人选本研究，肾移植手术完成时在移植肾上极的皮质内及切口附近皮下各放置一根微透析管进行微透析，每1小时平衡交换后，透析液行葡萄糖分析，并同时点行外周动脉血葡萄糖监测。监测持续时间中位数为111（62—211）h。结果术后最初12h内动脉血、移植肾组织葡萄糖浓度均明显高于12h后（P〈0．05），皮下组织葡萄糖浓度与12h后相比无统计学差异（P=0．243）；动脉血、移植肾组织及皮下组织三者间葡萄糖水平两两相关，但动脉血与移植肾组织二者间葡萄糖水平相关性良好（r=0．82）。结论①微透析技术可用于持续监测移植肾术后早期的葡萄糖变化，操作简单安全。②动脉血、移植肾组织及皮下组织三者之间葡萄糖有相关性，且血葡萄糖与肾脏组织葡萄糖水平相关性良好。

The Correlative Research of Glucose among Blood, the Graft and Subcutaneous Tissue Early after Living Related Donor Renal Transplantation

Objective By monitoring of glucose concentration and its change of artery blood and the graft tissue and subcutaneous early after living relative donor renal transplantation to find the correlation amony them and detect complications of the graft as early as possible. Methods Nine cases patients with end stage renal disease and undergoing living relative donor renal transplantation were studied. At the end of the operation, one microdialysis catheter was placed in the cortex of the upper graft and another was placed in the subcutaneous tissue near the incision to microdialyse. After per hour, s exchange balance, the collected dialysates were analysed for glucose concentration. At the same time point, artery blood sample was tested for glucose concentration. These monitorings were performed for a media duration of 1 l lh （62-211h）. Results During the first 12h after operation, the glucose concentrations of the artery and the graft were higher than 12 hours later （P 〈 0.05 ）, but there was no statistical difference of the subcutaneous tissue compared with 12 hours later （P=0.243）. There were correlations of glucose concentration among the artery blood, the graft and subcutaneous tissue and the correlation between the graft and blood was significant （r=0.82）. Conclusion ① Microdialysis allows continuous monitoring of glucose concentration of the graft early after renal transplantation . The procedure is easy to perform and safe. ② There were correlations of glucose concentration amony the artery blood, the graft and subcutaneous tissue. The correlation between the blood glucose level and the graft is good.