硬膜外麻醉下胆囊切除术对骨胳肌葡萄糖转运蛋白-4mRNA表达的影响  

The effect of cholecystectomy under epidural block on glucose transport-4 mRNA expression in skeletal muscle

作　　者：钱燕宁[1] 胡有力[1] 刘存明[1] 张国楼[1] 傅诚章[1] 林桂芳[1] 

机构地区：[1]南京医科大学第一附属医院麻醉科,210029

出　　处：《中华麻醉学杂志》2002年第7期396-398,共3页Chinese Journal of Anesthesiology

基　　金：江苏省教委资助项目(批准号96046)

摘　　要：目的 观察上腹部手术对骨骼肌葡萄糖转运蛋白-4（Glut4）mRNA表达的影响。方法硬膜外麻醉下经腹胆囊切除术患者10例,分别于进腹和关腹时取腹直肌1g,用Trizol一步法抽提肌细胞总RNA,通过RT-PCR方法,获得Glut4 mRNA扩增产物,每例表达值以（目的基因/β-actin）×100％表示,同时测定进腹和关腹时血糖、胰岛素值。结果 与进腹时相比较,关腹时Glut4 mRNA表达值明显降低（P<0.05）,血糖明显升高（P<0.05）。血浆胰岛素水平无明显改变（P>0.05）。结论上腹部手术后,肌细胞Glut4 mRNA的表达明显降低。本结果提示应激状态下,Glut4的合成受到影响,可导致术后胰岛素拮抗现象。Objective Surgical stress induces a series of endocrine and metabolic changes including glucose metabolism and insulin-resistance. The purpose of the present study was to investigate the changes in glucose transporter-4 (Glut-4) mRNA expression in skeletal muscle after cholecystectomy under epidural block. Methods One gram of the rectus abdominis muscle was taken while abdomen was being opened and closed in patients undergoing cholecystectomy under epidural block. Total RNA of the muscle cells was extracted by trizol one-step template. RT-PCR was used to determine the Glut-4 mRNA amplification products with β-actin mRNA as an internal control. The Glut-4 mRNA expression was expressed by (desired gene/ β-actin×100% . The plasma glucose and insulin levels were determined at the same time. Results Glut-4 mRNA expression was significantly reduced (P<0.05) and plasma glucose level increased ( P < 0.05 ), while abdomen was being closed as compared with those while abdomen was being opened. Plasma insulin level did not change significantly after operation ( P > 0.05 ) . Conclusions The results indicated that the synthesis of Glut-4 is suppressed by surgical stress of cholecystectomy under epidural block leading to insulin resistance.

关 键 词：硬膜外麻醉 胆囊切除术 骨骼肌 mRNA 葡萄糖转运蛋白-4 

分 类 号：R614.42[医药卫生—麻醉学]