旷置上段空肠对2型糖尿病大鼠降糖作用的研究  

The antidiabetie effect of jejunal exclusion surgery for T2DM rats

作　　者：冯宁[1] 林峰[1] 康新[1] 薛帆[1] 崔佑刚[1] 张旭[1] 衣宇鹏 孔祥余 刘文志[1] Feng Ning;Lin Feng;Kaug Xin;Xue Fan;Cui Yougang;Zhaug Xu;Yi Yupeng;Kong Xiangyu;Liu Wenzhi(Department of Gastrointestinal Surgery, the Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China)

机构地区：[1]大连大学附属中山医院胃肠外科,116001

出　　处：《中华内分泌外科杂志》2018年第3期183-187,共5页Chinese Journal of Endocrine Surgery

基　　金：2013年大连市卫生与计划生育委员会医学科学研究计划项目（1311108）

摘　　要：目的 观察空肠旷置术对链脲佐菌素诱发的2型糖尿病（T2DM）SD大鼠的治疗效果及其机制。方法60只SD大鼠经腹腔注射链尿佐菌素后建立T2DM模型，选取成模T2DM大鼠55只随机分为3组，手术组20只（A组），假手术组20只（B组）和对照组15只（C组）。A组行空肠旷置术，B组行空肠切断吻合术，C组正常喂养。测定术前（0周）及术后1、2、4、8、16周各组大鼠体质量（g）、空腹血糖（mmol／l）、空腹血浆胰岛素（INR）及血浆胰高血糖素样肽-1（GLP-1）水平。结果与假手术组及对照组比较，手术组术后2、4、8、16周体质量分别下降至（3521±9.00）g、（342.84±8.90）g、（336.64±10.26）g、（330.34±9.12）g,与术前（369.14±8.05）g相比差异有统计学意义（p〈0.05）；术后2、4、8、16周手术组血糖明显下降，分别为（14.62±1.10）mol／L、（12.12±1.38）mol／L、（8.75±1.06）mmol／L、（7.55±1.00）mmol／L，与术前（16.85±0.92）mmol／L相比差异有统计学意义（尺0.05）；术后2、4、8、16周手术组胰岛素水平分别上升至（14.62±3.10）mU／L、（16.12±3.38）mU／L、（17.75±4.06）mU／L、（17.55±3.10）mU/L，与术前（10.85±5.92）mU／L相比差异有统计学意义（P〈0.05），至术后8—16周手术组大鼠胰岛素水平达到平稳状态，并与相同时间点假手术组、对照组相比较胰岛素水平明显升高（P〈0.05）；手术组术后1、2、4、8、16周GLP.1值分别上升至（11.02±0.85）pmol／L、（14.42±1.18）pmol／L、（16.02±1.59）pmol／L、（17.62±1.02）pmol／L、（18.12±0.71）pmol／L，与术前（7.61±0.70）pmol／L相比差异有统计学意义（P〈0.05），术后1-16周与对照组各时间点大鼠的GLP-1值相比差异均有统计学意义（P〈0.05），且随时间的增加，手术组大鼠的GLP.1值升高越来越明显。结论空肠旷置术可有效控制T2DM大鼠的血糖，降糖疗效理想并持久�Objective To study the curative effects of jejunal exclusion surgery for STZ±induced T2DM SD rats. Methods 60 SD rats were induced to be the T2DM SD rats by intraperitoneal injection of streptozotoci± hi. As a result, 55 T2DM SD rats were successfully acquired which were randomly divided into 3 groups, 20 rats in the jejunal exclusion group （A）, 20 rats in the sham operation group （B） and 15 rats in the control group （C）. Jejunal exclusion surgery was performed in group A, jejunojejunostomy was performed in group B, and group C were fed normally. The body weight, fasting blood glucose, fasting plasma insulin level and GLP±1 level were measured before operation and at the 1st, 2nd, 4th, 8th and 16th week after operation. Results As compared with that before operation and that of the control group, the body weight in group A markedly declined at the 2nd,4th, 8th and 16th week （352.14＋9.00, 342.84＋8.90, 336.64＋10.26, 330.34＋9.12,P〈0.05）. The fasting plasma glu± cose levels in group A markedly declined at the 2nd, 4th, 8th and 16th week （14.62：1：1.10, 12.12±1.38, 8.75± 1.06, 7.55±1.00 ,P〈0.05 ）. The fasting plasma insulin level in group A was markedly increased at the 2nd , 4th, 8th and 16th week （14.62±3.10, 16.12±3.38, 17.75±4.06, 17.55±3.10,P〈0.05）. GLP±1 level in group A was markedly increased at the 1st, 2nd, 4th, 8th and 16th week （11.02±0.85, 14.42±1.18, 16.02±1.59, 17.62±1.02, 18.12±0.71, P〈0.05）. Conclusions The jejunal exclusion surgery is effective in controlling blood glucose, which is an ideal and lasting method. This surgery has also showed influence on body weight.

关 键 词：空肠旷置术 2型糖尿病 血糖 

分 类 号：R656[医药卫生—外科学]