结肠切除术后大鼠血浆及小肠内胰高血糖素样肽-2水平的变化  

Changes of glucagon-like peptide-2 expression in serum and ileum after colectomy in rats

作　　者：刘豫隆[1] 韦佳[1] 李宁[1] 向磊[1] 张洪毅[1] 冯杰雄[1] 

机构地区：[1]华中科技大学同济医学院同济医院小儿外科,武汉430030

出　　处：《中华实用儿科临床杂志》2013年第11期828-831,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：国家自然科学基金（81270441）

摘　　要：目的研究结肠切除术后血浆及小肠内胰高血糖素样肽-2（GLP-2）的表达，并比较不同范围结肠切除术后GLP-2的变化。方法选用3～4月龄SD大鼠80只，180～250g、雌雄不拘，依据手术方式将大鼠随机分为4组：对照组、假手术组、左半结肠切除组、结肠次全切组。假手术组行腹壁切开及缝合术。每组根据处死大鼠时间，进一步分为术后0、10、20、30d4个亚组，每个亚组5只大鼠。心脏穿刺收集全血。术后分别采用ELISA法检测各组大鼠血浆GLP-2水平，免疫组织化学法检测末端回肠GLP-2表达，并行石蜡切片HE染色观察小肠绒毛长度变化。结果GLP-2蛋白散在分布于小肠纤维母细胞、上皮细胞及小肠腺细胞胞质内。与对照组、假手术组比较，左半结肠切除组大鼠血浆及小肠中GLP-2水平升高最为显著，且随时间延长而增高（P均〈0．05）；而结肠次全切组血浆及小肠中GLP-2水平与术前比较均未见明显差异。术后加d和30d时，左半结肠切除组小肠肠段绒毛高度明显高于对照组和假手术组（P均〈0．05），而结肠次全切组小肠绒毛高度与对照组和假手术组比较未见明显增高（P均〉0．05），其变化与GLP-2蛋白表达变化一致。结论适度的结肠切除后小肠GLP-2水平会代偿性增高，但结肠肠段切除过多（次全切）后小肠GLP-2则无代偿性增高，可能与结肠次全切除术后肠功能恢复较慢有关。Objective To explore the effect of colectomy on the expression of glucagon-like peptide-2 （ GLP-2） in serum and ileum and compare the changes of GLP-2 after different colectomy in rats. Methods Eighty male or female rats,aging 3-4 months old, were recruited in this study. The rats weight 180-250 g. The 80 rats were evenly and randomly distributed into 4 groups according to the surgical procedures they underwent：control group,in which the rats were not performed any procedures; sham surgery group, in which the rats underwent laparotomy;lefi hemieoleetomy group,in which the rats were performed left hemicoleetomy; and subtotal coleetomy group, in which the rats were per-formed subtotal colectomy. According to execution time, each group had 4 subgroups, including 0 day group, 10 day group,20 day group and 30 day group, and 5 rats were included in each subgroup. The whole blood was collected through cardiac puncture. Serum was collected and GLP-2 in serum was determined by enzyme-linked immunosorbent assay. The GLP-2 in ileum was studied by immunohistochemistry staining. The length of villus of ileum was also mea-sured by HE staining. Results The protein of GLP-2 was found in fibroblasts, epithelium and endocrine cells in ileum. Compared with control group and sham surgery group, the expressions of GLP-2 in serum and ileum increased signifi-cantly in the rats that underwent left hemicoleetomy after surgery（all P 〈0.05） ,and it was increasing with time. The villus length of the rats underwent left hemicolectomy also increased significantly compared with the control group and sham surgery groups 20 days and 30 days after surgery （ all P 〈 0.05 ）. The expressions of GLP-2 in serum and ileum and villus length of the rats with subtotal eoleetomy were not significantly different from those of the control group and sham surgery group （ all P 〉 0.05 ）. Conclusions The expressions of GLP-2 in serum and ileum are elevated after left hemicolectomy but not in subtotal coleetomy,which may be related to the

关 键 词：胰高血糖素样肽-2 结肠切除术 肠道代偿 

分 类 号：R656[医药卫生—外科学]