胃转流术对2型糖尿病大鼠围手术期死亡率的影响及其可能机制  

Influence of gastric bypass operation on perioperative mortality rate in type 2 diabetes rats and its possible mechanism

作　　者：任泽强[1] 张蓬波[1] 章红[2] 黄智龙 张秀忠[1] 龚帅[1] 姚丹[1] 

机构地区：[1]徐州医学院附属医院普外科,江苏徐州221002 [2]徐州医学院附属医院手术室,江苏徐州221002 [3]兰陵县人民医院普外科,山东兰陵277700

出　　处：《徐州医学院学报》2014年第10期679-681,共3页Acta Academiae Medicinae Xuzhou

基　　金：徐州市科技计划资助（XM12B028）

摘　　要：目的观察胃转流术（gastric bypass，GBP）对2型糖尿病大鼠围手术期死亡率的影响，并探讨其可能机制。方法健康雄性SD大鼠建模后随机分为糖尿病手术组（DO组）、糖尿病假手术组（DS组）及糖尿病对照组（DC组，每组8只）。DO组行GBP手术。术前及术后第1、2、4、8周分别测各组空腹血糖（FPG）。记录术后死亡率，尸检观察大鼠死亡原因。结果DO组术后第8周FPG由术前的（17．80±2．26）mmol／L下降到（6．18±0．53）mmol／L（P〈0．05），术后第2周开始各时间点DO组的FPG明显低于相应时间点DC组和DS组血糖（P〈0．05）。DO组大鼠死亡2只（2／8），其中1只死于胃肠吻合口漏，另1只尸检时未发现明显异常。DS组死亡4只（4／8），其中1只死于胃肠吻合口漏，另3只尸检时未发现明显异常。结论GBP能明显降低2型糖尿病大鼠的血糖水平，且能降低围手术期死亡率，其可能机制为改善了机体内环境紊乱，提高了机体对创伤应激的耐受性。Objective To observe the influence of gastric bypass operation on perioperative mortality rate in type 2 diabetes rats and to explore its possible mechanism. Methods Healthy male SD rats were randomly divided into type 2 diabetes operation group （DO group）, type 2 diabetes shame operation group （DS group） and type 2 diabetes control group （DC group）. Plasma glucose concentrations were measured at fasting condition before operation and 1,2, 4, and 8 weeks postoperatively, respectively. Results The fasting blood sugar level was decreased in DO group. The FBG decreased from （17.80 ±2.26） mmol/L （preoperatively） to （6.18 ±0.53 ） mmol/L （8 weeks postoperatively） （P 〈 0.05）. The plasma sugar in DC group was higher than in DO group at corresponding time （ P 〈 0.05 ）. In DO group, two rats died （2/8）, one of them died of gastrointestinal anastomotic leakage and autopsy showed no obvious abnormalities in the other one. While in DS group, four rats died （4/8）, one of them died of gastrointestinal anastomotic leakage and autopsy showed no obvious abnormalities in the other three. Conclusions Gastric bypass operation has a good hypoglycemic effect on rats with type 2 diabetes mellitus. GBP can reduce the perioperative mortality rate. The possible mechanism is that GBP can improve the internal environment disorder and posttraumatic stress tolerance.

关 键 词：胃转流术 2型糖尿病 血糖 围手术期 死亡率 

分 类 号：R587.1[医药卫生—内分泌]