两种外科手术治疗大鼠非肥胖2型糖尿病的疗效对比  

Efficacy comparison between two kinds of gastric bypass surgery for non-obese type 2 diabetes mellitus in rats

作　　者：黄盛[1] 檀建勇[1] 戴露倢[1] 邓治洲[1] 邹忠东[1] 王瑜[1] 

机构地区：[1]南京军区福州总医院普通外科,福州350025

出　　处：《第二军医大学学报》2011年第2期187-190,共4页Academic Journal of Second Military Medical University

基　　金：福建省重点科技计划项目(2009Y0039);南京军区医学科技创新重点项目(09Z031)~~

摘　　要：目的对比Roux-en-Y胃转流术及胆胰分流术治疗大鼠非肥胖2型糖尿病的疗效。方法 48只雄性Goto-Kakizaki(GK)大鼠随机分为Roux-en-Y胃转流术(Roux-en-Y gastric bypass,RYGBP)、胆胰分流术(billiopancreatic diver-sion,BPD)和假手术组,每组16只。检测术前及术后1、3、6、9、12、24周空腹血糖、胰岛素水平,检测术前及术后6、12、24周糖化血红蛋白,计算胰岛素抵抗指数(HOMA-IR),观察术后各组死亡率和并发症。结果术后1～24周Roux-en-Y胃转流术、胆胰分流术组空腹血糖显著降低(P<0.05,P<0.01),术后12、24周糖化血红蛋白显著降低(P<0.01);假手术组上述指标均未见显著变化。各组空腹胰岛素水平差异无统计学意义。与术前相比,Roux-en-Y胃转流术组和胆胰分流术组术后1～24周HOMA-IR指数显著降低(P<0.05);同时间点两组间比较,术后1～24周胆胰分流术组HOMA-IR指数显著低于Roux-en-Y胃转流术组(P<0.05)。Roux-en-Y胃转流术组死亡率为6%,胆胰分流术组死亡率达50%,胆胰分流术组术后并发症及死亡率均高于Roux-en-Y胃转流术组(P<0.05)。结论 Roux-en-Y和胆胰分流术治疗大鼠非肥胖2型糖尿病疗效相近,但胆胰分流术术后并发症和死亡率高于Roux-en-Y胃转流术。Objective To compare the efficacies of Roux-en-Y gastric bypass （RYGBP） and billiopancreatic diversion （BPD） in treatment of rats with non-obese type 2 diabetes mellitus. Methods Totally 48 Goto-Kakizaki rats were randomized to undergo one of the following procedures： Roux-en-Y gastric bypass （n = 16）, biliopancreatic diversion （n = 16）, and sham operation （n= 16）. The fasting blood glucose and fasting insulin were determined before and 1, 3, 6, 9, 12, and 24 weeks after operation; the hematoglobin Ale （HbAlc）levels were determined before and 6, 12, and 24 weeks after operation and the insulin resistance index （HOMA-IR） was calculated. The mortality and complications were observed in each group. Results The fasting blood glucose levels were significantly decreased during 1-24 weeks after operation in both Roux-en-Y group and biliopancreatic diversion group（P＇~0.01 or P^0.05） ; the HbAlc levels were also decreased 12 and 24 weeks after operation （P〈0.01）; and the above parameters were not significantly changed in the sham operation group. The fasting insulin levels were not significantly different between the 3 groups. In RYGBP group and the BPD group, the HOMA-IR indices decreased significantly 1-24 weeks after operation compared with those before operation （P^0. 05）, and those in the BPD group were significantly lower than those in the RYGBP group at all time points （P〈0.05）. The mortality was 6~ in the RYGBP group and 50~ in the BPD group. The complication rate and mortality in the BPD group were significantly higher than those in the RYGBP group （P（0.05）. Conclusion RYGBP and BPD have similar efficacies in treatment of rats with non-obese type 2 diabetes mellitus, and BPD can lead to higher incidences of complications and mortalities than RYGBP.

关 键 词：2型糖尿病 胃转流术 胆胰分流术 ROUX-EN-Y吻合术 

分 类 号：R587.1[医药卫生—内分泌] R656.6[医药卫生—内科学]