不同剂量胰岛素对短肠综合征大鼠蛋白质代谢及肠道代偿功能的影响  

Effect of different dosage of insulin on protein metabolism and intestinal adaptation in a rat model of short bowel syndrome

作　　者：闫明文 周安堂 王彩霞 朱维铭[2] 黎介寿[2] 

机构地区：[1]阳谷县人民医院普外科,山东阳谷252300 [2]南京军区南京总医院全军普外研究所

出　　处：《外科理论与实践》2008年第5期427-430,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨不同剂量胰岛素对SD短肠大鼠蛋白质代谢及其残存肠道代偿功能的影响。方法:切除32只SD雄性大鼠85%以上小肠,制成短肠综合征(SBS)模型,将其随机分为短肠综合征组(SBS,n=8)、低剂量胰岛素组(LINS,n=8)、中剂量胰岛素组(MINS,n=8)和高剂量胰岛素组(HINS,n=8)。术后第3～14天每天2次皮下注射胰岛素,每次LINS组为1U/kg,MINS组2U/kg,HINS组4U/kg,SBS组注射等量生理盐水。术后第15天检测血浆蛋白及测量肠代偿功能指标及肠上皮细胞增殖情况。结果:各胰岛素组大鼠体重比SBS组明显增加,血浆蛋白和肠代谢指标明显增加。与LINS组比较,MINS、HINS组大鼠体重均明显增加;空、回肠肠绒毛高度、隐窝深度显著增加(P<0.05);呈现正氮平衡,血浆蛋白增加,空、回肠粘膜DNA和蛋白质明显增加;肠黏膜细胞增殖明显增加(P<0.05)。MINS与HINS组间各项指标无明显差异。结论:适当增加胰岛素剂量能明显促进短肠综合征大鼠蛋白质合成和肠道代偿作用,其作用是非剂量依赖型的。Objective To investigate the effects of different dosage of insulin on protein metabolism and intestinal adaptation in a rat model of short bowel syndrome. Methods Thirty-two male SD rats submitted to massive intestinal resection were divided into 4 experimental groups： short bowel syndrome （SBS） group （n=8）, low dose insulin （LINS） group （n=8）, median close insulin （MINS） group （n=8） and high dose insulin （HINS）group （n=8）. Insulin was given subcutaneously B.I.D at doses of 1,2＆4 U/kg in the LINS,MINS,HINS groups from day 3 to 14 after operation. Serum protein and intestinal adaptation, enterocyte proliferation were determined on day 15 after the operation. Results Weight loss of rats in the insulin groups was significantly less than that in the SBS group, and serum protein levels, intestinal adaptation parameters were higher in those groups. Weight of rats, villus height and crypt depth of the jejunal and the ileum, and also their cell proliferation index were significantly increased in the MINS and HINS groups as compared to those of the LINS group （P〈0.05）. The MINS and HINS groups had earlier positive nitrogen balance, higher serum protein levels, higher jejunal and ileal mucosal DNA and protein levels, as compared to those of the SBS animals （P〈0.05）. No significant difference in the parameters was observed between the MINS and HINS groups （P〉0.05）. Conclusions Reasonablely increasing the dosage of insulin can promote positive protein metabolism and stimulate structural intestinal adaptation in a rat SBS model;however, the effects are not strictly dose-dependant.

关 键 词：短肠综合症 胰岛素 蛋白质代谢 肠吸收 

分 类 号：R656.7[医药卫生—外科学]