Roux-en-Y胃转流术对GK大鼠炎症因子与胰岛素抵抗影响的实验研究  

Impact of Roux-en-Y Gastric Bypass Surgery on Inflammatory Factors and Insulin Resistance of GK Rats

作　　者：邹洪[1,2] 闫洪涛[2] 伍松[2] 唐均成[2] 汤礼军[2] 

机构地区：[1]泸州医学院,四川646000 [2]成都军区总医院普外中心

出　　处：《西南军医》2012年第4期563-566,共4页Journal of Military Surgeon in Southwest China

基　　金：全军临床高新技术重大项目(2010gxjs040)

摘　　要：目的探讨Roux-en-Y胃转流术对自发糖尿病GK大鼠炎症因子与胰岛素抵抗的影响及其意义。方法 40只GK大鼠随机平均分为手术组与对照组。手术组行Roux-en-Y胃转流术,对照组行胃窦十二指肠离断后原位吻合术。分别于术前,术后1、2、4周动态检测两组大鼠血液中空腹血糖、口服葡萄糖耐量试验(OGTT)2 h血糖,空腹胰岛素;并于术前及术后4周测定大鼠血液中游离脂肪酸(free fatty acids,FFA)、肿瘤坏死因子α(TNF-α)、C-反应蛋白(CRP),计算胰岛素抵抗指数(HOMA-IR)。结果手术组术后空腹及OGTT2h血糖值均呈明显的下降趋势,至术后第4周时其血糖值显著低于术前(9.8±2.6)mmol/L降至(7.3±2.2)mmol/L及OGTT2h血糖(27.3±3.1)mmol/L降至(23.6±3.4)mmol/L(P<0.05);对照组手术前后空腹及OGTT2h血糖值无显著变化(P>0.05)。术后第4周,手术组大鼠血液FFA较术前显著降低(204.2±55.6)umol/L降至(179.4±32.54)umol/L(P<0.05);术后4周血中TNF-α的含量较术前显著降低(32.4±1.3)pg/ml降至(24.9±1.0)pg/ml(P<0.01);术后4周CRP的含量显著低于术前(648.5±36.23)ng/ml降至(32.9±37.8)ng/ml(P<0.01);而手术前后空腹胰岛素水平无显著变化(P>0.05),其HOMA-IR指数较术前显著降低(8.46±1.66降至5.20±0.79)(P<0.05);而对照组术后4周上述指标无显著差异(P>0.05)。结论 Roux-en-Y胃转流术能显著降低GK大鼠的血糖,其可能机制是手术后通过降低体内游离脂肪酸含量,导致炎症因子释放减少,从而使胰岛素抵抗得到缓解。Objective To explore the impact of Roux - en - Y gastric bypass surgery on inflammatory factors and insu- lin resistance of GK rats. Methods 40 GK rats were randomly divided into 2 groups ： surgery group and control group, 20 rats in each ; Roux - en - Y gastric bypass surgery was performed on rats in surgery group while antroduodenal anas- tomosis surgery to rats in control group ; before surgery and 1 week, 2 weeks and 4 weeks after surgery, dynamic detec- tion of fasting plasma glucose, oral glucose tolerance test blood glucose 2h （OGTI＇2h） and fasting insulin with the HO- MA - IR was made to rats in both groups ; before surgery and 4 weeks after surgery, the free fatty acid （ FFA）, tumor necrosis factor - α （ TNF - alpha）, C - reactive protein （CRP） and insulin resistance index （ HOMA - IR） of the rats in both groups were detected. Results Of the rats in surgery group, the fasting insulin and OGTT2h decreased signifi- cantly, the fasting glucose decreased even more to 7.3 ± 2. 2mmol./L and much lower than that before surgery （9. 8± 2.6mmoL/L） 4 weeks after surgery （P 〈0.05） while OGTT2h from 27.3 ±3. lmmol/L to 23.6 ±3.4 mmol/L （P 〈 0. 05 ） ; of the rats in control group, no obvious decrease was observed in fasting glucose and OGTT2h （P 〈 0.05 ） ; 4 weeks after surgery, of the rats in surgery group, FFA, TNF - alpha and CRP decreased obviously after surgery and were much lower than those before surgery （ FFT from 204. 2 ± 55.6umoL/L to 179.4 ± 32.54umo]./L （ P 〈 0. 05 ） , TNF - alpha from 32.4 ± 1.3pg/ml to 24. 9 ± 1.0 pg/ml （ P 〈 0. 01 ）, CRP from 648.5 ± 36.23ng/ml to 32.9 ± 37.8ng/ml （P 〈0. 01 ）） （P 〈0. 05）; the fasting insulin level before and after surgery had no obvious changes and HOMA - IR dropped down much more than that before surgery （ from 8.46 ± 1.66 to 5.20 ± 0.79 ） （ P 〈 0. 05 ） ; all theabove index of the rats in control group had no obvious changes （P 〈 0.05 ）. Conclusions Roux - en - Y gast

关 键 词：胃转流术 GK大鼠 炎症因子 胰岛素抵抗 

分 类 号：R656.61[医药卫生—外科学]