波动血糖对糖尿病大鼠肾脏和肝脏损伤的影响  

Effects of fluctuant high blood glucoes on liver and kidney injury in diabetic rats

作　　者：李素娟[1] 高凯旋 杨文娟[1] 钱竹青[1] 王猛[1] 吴德平[1] 

机构地区：[1]中国人民解放军第八二医院内分泌科,江苏淮安223001

出　　处：《中国医学前沿杂志（电子版）》2015年第11期33-37,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：浙江省自然科学基金资助项目(Y207495);南京军区科技创新课题项目(12MA026);淮安市内分泌代谢性疾病重点实验平台持续支持项目(HAP201273)

摘　　要：目的探讨波动高血糖引起糖尿病大鼠肾脏和肝脏损伤的机制。方法将SD大鼠随机分为N组(正常对照组)、D组(稳定高血糖组)、F组(波动血糖组),D组、F组大鼠均一次性腹腔内注射链脲佐菌素(STZ)65 mg/kg,建立糖尿病模型。F组大鼠每天错时给予胰岛素和葡萄糖造成血糖波动模型。12周后测定各组大鼠血清谷草转氨酶(AST)和谷丙转氨酶(ALT)、肌酐、尿素氮水平,收集24小时尿液测定尿微量蛋白和尿蛋白定量,观察肾、肝脏显微和超微结构变化。结果 F组大鼠1天中的血糖浓度出现明显波动,D组大鼠1天中的血糖浓度基本处于高水平状态。N组大鼠糖化血红蛋白(Hb A1c)为(5.10±0.32)%,D组为(10.50±0.69)%,F组为(10.13±0.96)%,D组与F组比较无明显差异(P>0.05)。与N组比较,D组和F组大鼠的肝指数均明显升高(分别为P<0.05,P<0.01),D组和F组大鼠的AST、ALT水平均明显升高(P<0.01)。与D组比较,F组大鼠肝指数、AST、ALT水平均明显升高(P<0.01)。与N组比较,D组和F组大鼠24小时尿微量蛋白、尿蛋白定量和血清肌酐和尿素氮水平均明显升高(P<0.05,P<0.001)。与D组比较,F组大鼠24小时尿微量蛋白、尿蛋白定量均明显升高(P<0.05,P<0.001)。三组大鼠肝脏和肾脏显微和超微结构明显改变。结论糖尿病大鼠12周时肾、肝脏出现明显损伤,且血糖波动能够加重其损伤程度。Objective To explore the mechanisms of fluctuant high blood glucose induced injury on liver and kidney. Method SD rats were randomly divided into normal control group（N）, stable high blood glucose group（D）, fluctuant high blood glucose group（F）. Diabetic rats were induced by intraperitoneal injection of streptozotocin（STZ, 65 mg/kg）, established the diabetes model. Rats in group F were given insulin and glucose to cause blood glucose fluctuation model. After 12 weeks, serum AST and ALT, creatinine, urea nitrogen level of rats were measured, Urine samples were collected for 24 hours to measure urinary micro protein and urinary protein, and to observe the changes of microstructure and ultrastructure of kidney, liver and kidney. Result The blood glucose concentration of group F was obviously fluctuated in the 1 day, and the blood glucose concentration in group D was basically in the high level in 1 days. The Hb A1 c of group N was（5.10±0.32）%, group D was（10.50±0.69）%, group F was（10.13±0.96）%, there was no significant difference between group D and group F（P〉0.05）. Compared with group N, liver index of group F and group D were significantly increased（P〈0.05, P〈0.01）, AST and ALT levels of group F and group D were significantly increased（P〈0.01）; compared with group D, liver index, AST, ALT levels of group F were significantly increased（P〈0.01）. Compared with group N, group D and f rats 24 hours urinary albumin, urinary protein and serum creatinine and urea nitrogen water average increased significantly（P〈0.05, P 0.001）; compared with group D, 24 hours urine trace protein, urinary protein of group F were significantly increased（P〈0.05, P 0.001）. The microstructure and ultrastructure of the liver and kidney were significantly changed in the three groups. Conclusion The kidney and liver of diabetic rats appeared obviously damage in the 12 week, blood glucose fluctuation can aggravate the injury degree.

关 键 词：血糖 糖尿病 大鼠 肝脏 肾脏 

分 类 号：R587.1[医药卫生—内分泌]