全胃切除术后家兔营养不良的实验研究  

Malnutrition following total gastrectomy in rabbits

作　　者：任重[1] 牛伟新[2] 刘寒[2] 何国栋[2] 王洪山[2] 高晓东[2] 

机构地区：[1]复旦大学附属上海第五人民医院普外科,200240 [2]复旦大学附属中山医院普外科,上海200032

出　　处：《中华消化外科杂志》2007年第3期198-202,共5页Chinese Journal of Digestive Surgery

摘　　要：目的通过建立家兔全胃切除和迷走神经干切断的模型,初步探讨全胃切除术后所引起的进食减少、体质量下降、营养不良的原因。方法新西兰兔24只,随机分为A组（对照组）、B组（全胃切除组）和C组（迷走神经干切断组）,观察B、C组手术后体质量比、进食量、血浆胆囊收缩素、胃动素含量、近段小肠上皮单糖转运体GLUT5和SGLT1的mRNA表达情况等指标,并和A组比较。结果与A组相比,B组术后体质量比、进食量明显下降。家兔术后血浆胃动素含量变化不大,胆囊收缩素含量分别于术后第3天和第14天升高（P〈0.05）。B组家兔十二指肠和空肠GLUT5 mRNA表达显著下降（P〈0.05和〈0.01）。在十二指肠和空肠B组家兔SGLT1 mRNA表达均无变化（P〉0.05）。C组家兔术后上述指标与对照组比较,差异均无统计学意义（P〉0.05）。结论全胃切除术后与胃动素相关的消化间期小肠蠕动和食物排空速度可能未出现改变,而胆囊收缩素含量上升可能与中枢性摄食抑制？食欲下降有关;胃切除后家兔小肠近段GLUT5 mRNA表达明显下降,SGLT1 mRNA表达无变化。迷走神经干的切断在这些病理生理变化中不起重要作用。Objective To explore preliminarily the causes for anorexia, weight reduction and malnutrition after total gastrectomy by establishing rabbit model of total gastrectomy and vagotomy. Methods Twenty-four New Zealand rabbits were divided randomly into group A （control group）, group B （undergone total gastrectomy） and group C （ undergone vagotomy ） . The ratio of the weight, the amount of food taken, the content of cholecystokinin （CCK） and motlin in plasma, the expression of the mRNA of GLUT5 and SGLT1 at the epithelium of the proximal part of small intestine in groups B and C after operation were observed and compared with those in group A. Results Compared with group A, the ratio of the weight and the amount of food taken in group B were reduced more distinct｜y. The content of motiin in group B showed little change, while the content of CCK was elevated at days 3 and 14 after operations （ P 〈 0.05）. The expression of GLUT5 mRNA at duodenum and jejunum decreased notably in group B compared with group A （ P 〈0.05 and P 〈0.01 respectively）. But the expression of GLUT5 mRNA at duodenum and jejunum showed no statistical deference in group B compared with group A （ P 〉 0.05）. In group C, all these indices had no statistical deference compared with group A （P 〉 0. 05 ）. Conclusions After total gastrectomy, the peristalsis of small intestine and the evacuation of the food in interdigestive period correlated with motlin may not change, while the increase of the content of CCK may cause central feeding inhibition and anorexia. After total gastrectomy, the expression of GLUT5 mRNA at the proximal part of small intestine of the rabbits is decreased but that of SGLT1 mRNA remains unchanged. Vagotomy shows no contribution to all these pathophysiologic changes.

关 键 词：全胃切除术 迷走神经干切断术 营养不良 家兔 

分 类 号：R686[医药卫生—骨科学]