手术应激对肠上皮细胞胰岛素信号的影响  

Effect of surgical stress on insulin signal in intestinal epithelial cells

作　　者：陈洪流[1] 谭庆丰[1] 陈振勇[2] 

机构地区：[1]湖北民族学院附属民大医院普外科,湖北恩施445000 [2]华中科技大学同济医学院附属协和医院普外科

出　　处：《中华实验外科杂志》2014年第3期547-549,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 观察手术对肠道上皮细胞胰岛素信号通路的影响.方法 制作阻塞性黄疸大鼠模型,分别于手术前及手术后1、3、24h采血,计算胰岛素抵抗（IR）指数,免疫组织化学检测小肠上皮细胞胰岛素受体表达,Western blot检测肠上皮细胞胰岛素受体底物（IRS）-1、-2及蛋白激酶B（PKB）的表达.结果 手术组的IR指数在术后各时间点分别为3.40±0.12、4.29±0.11、5.34±0.18,其中24h值明显高于对照组和假手术组（P＜0.05）.手术组的胰岛素受体强阳性表达数分别为3/10、2/10、2/10,其中术后24h较其他时间点下降明显（P＜0.05）.手术组术后24h的胰岛素受体底物IRS-1相对表达量为0.42±0.04,较其他组下降明显（P＜0.05）,而各组的IRS-2变化不明显.PKB的相对灰度值（0.52±0.10）在手术组中也明显下降（P＜0.05）.结论 手术应激后IR的发生与肠上皮细胞的胰岛素受体表达降低及受体底物下降有关.PKB是术后IR信号途径中的重要一环.Objective To discuss the surgical effects on insulin signaling pathway in intestinal epithelial cells.Methods The obstructive jaundice models of rats were established,then peripheral blood samples were harvested before and at 120 min,4 h and 24 h after surgery,respectively.The insulin resistance （IR） index was calculated.The expression of insulin receptor in intestinal epithelial cells was detected by immunohistochemistry.The expression of the insulin receptor substrate （IRS-1,-2） and protein kinase B （PKB） was tested by Western blotting.Results The IR index in operation group was 3.40 ±0.12,4.29 ±0.11 and 5.34 ±0.18 at 120 min,4 h and 24 h after surgery,respectively.As compared with the control group,the IR index at 24 h was increased significantly in operation group （P ＜ 0.05）.The number of strong insulin receptor expression was 3/10,2/10,2/10 at 120 min,4 h and 24 h after surgery respectively,and the expression of insulin receptor at 24 h was reduced obviously （P ＜ 0.05）.The expression of IRS-1 was decreased （0.42 ± 0.04,P ＜ 0.05） after operation,but there was no significant change in the IRS-2 expression.The relative amount of PKB was also reduced in operation group （0.52 ±0.10,P ＜ 0.05）.Conclusion The occurrence of IR in intestinal epithelial cells is related to the reduced expression of insulin receptor and IRS after surgical stress.The low expression of PKB is an important factor of IR signaling pathway in intestinal epithelial cells.

关 键 词：手术应激 胰岛素抵抗 肠上皮 胰岛素受体 

分 类 号：R619.5[医药卫生—外科学]