改良胆胰转流术对GK大鼠的长期降糖效果  

Long-term effects of a new billiopancreatic diversion surgery on plasma glucose in Goto-Kakizaki rats

作　　者：张斌[1] 翁山耕[1] 何洪兴[1] 徐常国[1] 冯苏[1] 

机构地区：[1]福建医科大学附属第一医院肝胆胰外科,福建省福州市350005

出　　处：《世界华人消化杂志》2016年第11期1658-1663,共6页World Chinese Journal of Digestology

基　　金：国家自然科学基金资助项目;No.81341024;福建省自然基金资助项目;No.2014J01312;福建省卫计委中青年骨干人才培养重点基金资助项目;No.2014-ZQN-20-17;福建医科大学教授发展基金资助项目;No.JS14020~~

摘　　要：目的:观察改良胆胰转流术(new billiopancreatic diversion,NBPD)和十二指肠改道术(duodenaljejunal bypss,DJB)对GK大鼠的血糖、血脂的长期影响,并探讨其可能的降糖机制.方法:将30只12周龄♂SPF级GK大鼠随机分为3组,每组10只,分别行DJB、NBPD组和假手术.检测手术前后体质量、血糖、血脂等水平,观察术后48 wk胰岛细胞形态.结果:与本组术前1 wk随机血糖相比,术后1 wk NBPD和DJB组大鼠随机血糖下降(9.729 mmol/L±0.652 mmol/L vs 17.743mmol/L±3.734 mmol/L,9.367 mmol/L±1.118 mmol/L vs 16.500 mmol/L±3.272mmol/L).术后24 wk,NBPD组大鼠血糖升至18.043 mmol/L±6.970mmol/L,与假手术组相比差异无统计学意义,而DJB组大鼠随机血糖14.233 mmol/L±2.759 mmol/L,明显低于假手术组及NPBD组.术后48 wk,DJB组大鼠胰岛细胞数量较NBPD组和假手术组明显增多.结论:NBPD及DJB术后早期均能明显降低GK大鼠血糖,但NBPD术后长期降糖效果不佳.这可能是术后早期胆胰液转流影响了GK大鼠消化吸收功能,造成血糖降低.远期肠道功能代偿,而NBPD并无肠道旷置,从而造成血糖回升.AIM： To observe the effects of a new billiopancreatic diversion（NBPD） surgery and duodenal-jejunal bypass（DJB） on plasma glucose and blood lipids in Goto-Kakizaki（GK）rats, and to explore the possible mechanisms involved.METHODS： Thirty rats were randomly divided into an NBPD group, a DJB group and a sham operation group. Body weight, plasma glucose and blood lipids were measured before and after surgery. Morphology of islet cells was observed 48 weeks after surgery.RESULTS： One week after surgery, random plasma glucose level decreased from 9.729mmol/L ± 0.652 mmol/L to 17.743 mmol/L ±3.734 mmol/L in the NBPD group, from 9.367mmol/L ± 1.118 mmol/L to 16.500 mmol/L ±3.272 mmol/L in the DJB group, and both were significantly lower than those in the sham operation group. Twenty-four weeks after surgery, random plasma glucose level rose to14.233 mmol/L ± 2.759 mmol/L in the NBPD group. However, random plasma glucose level was still maintained at 14.233 mmol/L± 2.759 mmol/L in the DJB group, which was significantly lower than those in the NBPDand sham-operation groups. Forty-eight weeks after surgery, the number of islet cells in the DJB group was more than those in the other two groups.CONCLUSION： Both NBPD and DJB can decrease plasma glucose in GK rats in the early stage after surgery, but long-term effect of NBPD is not satisfactory. Biliopancreatic diversion may be an important factor in early stage. Changes in the digestive tract may be the most important factor involved in the surgical treatment of type 2 diabetes.

关 键 词：GK大鼠 十二指肠改道术 改良胆胰转流术 糖耐量 胰岛细胞 

分 类 号：R657.5[医药卫生—外科学]