不同胃肠吻合方式对非肥胖型2型糖尿病大鼠的降糖作用  

Blood glucose-lowering effect of different types of anastomosis in gastrojejunostomy on type 2 diabe- tes mellitus in Goto-Kakizaki rats

作　　者：焦亚彬[1] 王瑜[1] 邹忠东[1] 黄盛[1] 张再重[1] 邓治洲[1] 王祎波[1] 戴露倢[1] 王烈[1] 

机构地区：[1]福建医科大学福总临床医学院(南京军区福州总医院)普通外科,福州350025

出　　处：《中华实验外科杂志》2011年第3期377-379,共3页Chinese Journal of Experimental Surgery

基　　金：基金项目：福建省重点科技计划资助项目（2009Y0039）;南京军区医药卫生科研重点专项（092031）

摘　　要：目的 观察不同胃肠吻合方式对非肥胖型2型糖尿病（T2DM）大鼠的治疗作用.方法 将24只雄性Goto-Kakizaki（GK）大鼠随机分3组,分别为Roux-en-Y式、毕Ⅱ式胃转流术组和毕Ⅰ式组,每组8只.检测术前（0周）及术后1、3、6、12、24周空腹血糖及空腹血清胰岛素水平,采用稳态模型法计算胰岛素抵抗指数（HOMA-IR）.结果 与术前比较,毕Ⅰ式组空腹血糖、空腹胰岛素、HOMA-IR术后1～24周未见明显变化（P＞0.05）：而Roux-en-Y式、毕Ⅱ式组术后1～24周空腹血糖较术前显著降低（P＜0.01）,术后24周,空腹血糖由（12.56±2.97）、（12.96±3.01）mmol/L下降到（7.87±0.75）、（9.21±1.53）mmol/L;空腹胰岛素术后1～24周未见明显变化（P＞0.05）,HOMA-IR术后1～24周显著降低（P＜0.01）,术后24周,HOMA-IR由（11.92±1.45）、（12.69±2.03）下降到（6.66±1.25）、（7.97±0.68）.结论 毕Ⅰ式胃肠吻合术对2型糖尿病大鼠可能无治疗作用,Roux-en-Y式和毕Ⅱ式胃转流术可改善2型糖尿病大鼠胰岛素抵抗程度,有效控制血糖水平,且Roux-en-Y式胃转流术疗效优于毕Ⅱ式胃转流术.Objective To investigate the effect after gastrojejunostomy with different types of anastomosis in an animal model of nonobese type 2 diabetes.Methods Twenty-four Goto-Kakizaki rats randomly underwent one of the following procedures：gastric bypass with different types of anastomosis of Roux-en-Y （ n = 8）,Billroth Ⅱ （ n = 8 ） or Billroth Ⅰ （ n = 8 ）.Rats were observed for 24 weeks after surgery.Fasting blood glucose and insulin level were tested at 0,1,3,6,12,24 weeks and homeostasis model assessment of insulin resistance （HOMA-IR） was done.Results As compared with preoperation,fasting blood glucose levels,the fasting blood insulin level and the HOMA-IR level had no significant change in Billroth Ⅰ rats during the entire follow-up period （ P 〉 0.05）.In both Roux-en-Y and Billroth Ⅱ groups,fasting blood glucose levels were significantly decreased as early as 1 week after surgery and then kept a similar level during the entire follow-up period （P〈0.01 ）.Twenty-four weeks after operation,the fasting blood glucose levels was declined from （12.56 ±2.97）,（12.96 ±3.01） mmol/L to （7.87 ±0.75）,（9.21 ± 1.53） mmol/L;the fasting blood insulin levels were similar during the entire follow-up period （ P 〉0.05 ）.The HOMA-IR level was significantly decreased after surgery in both Roux-en-Y and Billroth Ⅱ groups during the follow-up period （ P〈0.01 ）.Twenty-four weeks after operation,the HOMA-IR level was declined from （11.92 ± 1.45）,（12.69 ±2.03） to （6.66 ± 1.25）,（7.97 ±0.68）.Conclusion Billroth Ⅰ reconstruction after gastrectomy is not effective on diabetes control.Roux-en-Y and Billroth Ⅱ gastric bypass in a nonobese diabetic model were effective in terms of glucose control and improving insulin resistance.But Roux-en-Y gastric bypass seems to be more effective than Billroth Ⅱ gastric bypass on antidiabetes.

关 键 词：2型糖尿病 胃转流 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]