胃袖状切除附加空回肠吻合术对ZDF大鼠GLP-1蛋白表达的影响  

Effect of sleeve gastrectomy plus side-to-side jejunoileal anastomosis on the expression of GLP-1 in ZDF rats

作　　者：周小钢[1] 王恺京[1] 徐安安[1] 高玮[1] 陆佳军 朱江帆[1] 

机构地区：[1]同济大学附属东方医院,上海200120

出　　处：《腹腔镜外科杂志》2015年第10期724-728,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨胃袖状切除加空回肠侧侧吻合术(sleeve gastrectomy plus side-to-side jejunoileal anastomosis,JI-SG)对糖尿病肥胖(Zucker diabetic fatty,ZDF)大鼠末端回肠黏膜组织胰高血糖素样肽-1(glucagon-like peptide 1,GLP-1)蛋白表达及空腹血糖的影响,探讨其降糖的可能机制。方法:将30只ZDF大鼠随机分为假手术(sham surgery,SS)组、胃袖状切除(sleeve gastrectomy,SG)组、JI-SG组,术后同等条件下饲养12周,观察血清血糖、GLP-1及胰岛素水平,于术后12周末检测GLP-1蛋白在回肠末端组织中的表达。结果:JI-SG组、SG组回肠末端GLP-1蛋白表达阳性率高于SS组(P<0.05),伴有L细胞增生;JISG组较SG组有显著性升高(P<0.05)。SG组、JI-SG组血糖水平较SS组明显下降(P<0.05),同时JI-SG组较SG组降糖效果更加明显(P<0.05)。SG组、JI-SG组血清胰岛素水平较SS组明显下降(P<0.05),同时JI-SG组低于SG组(P<0.05)。SG组、JI-SG组血清GLP-1水平较SS组明显升高(P<0.05),同时JI-SG组高于SG组(P<0.05)。结论:JI-SG可显著增强回肠末端GLP-1蛋白表达,同时伴有L细胞增生,可能是其具有显著且持续稳定降糖作用的原因。Objective： To investigate the mechanism involved on the expression of glucagon-like peptide 1（ GLP-1） in ileal mucosal tissue and decrease of fasting blood glucose（ FBG） after sleeve gastrectomy with side-to-side jejunoileal anastomosis（ JI-SG）in ZDF rats. Methods： Thirty male ZDF rats were randomly assigned to three groups： sham surgery（ SS）,sleeve gastrectomy（ SG） and JI-SG. All groups were kept in the same environment for 12 weeks and then FBG,plasma levels of insulin and GLP-1 were monitored regularly. The level of GLP-1 expression in ileal mucosal tissue was detected at the end of the 12 week. Results： The positive rate of GLP-1 expression in terminal ileum along with the proliferation of L cell in JI-SG and SG groups was significantly higher than that of SS group. Compared with the SG group,the immunohistochemical change was more obvious in JI-SG group（ P〈0. 05）. Compared with SS group,the level of FBG decreased in the JI-SG group and SG group,while the level of FBG in JI-SG group was significantly decreased as compared with the SG group. Compared with SS group,the level of plasma insulin level decreased and the GLP-1 level increased in the JI-SG group and SG group,whereas the JI-SG group significantly decreased the level of plasma insulin and elevated level of plasma GLP-1 as compared with that of the SG group. Conclusions： JI-SG leads to the significant increase in the level of GLP-1 expression along with the proliferation of L cell in ileum mucosal tissue,which maybe the possible reason for the sustained and stable hypoglycemic effect.

关 键 词：胃袖状切除 空回肠吻合术 胰高血糖素样肽1 血糖 胰岛素 

分 类 号：R656[医药卫生—外科学]