血糖波动对糖尿病大鼠心脏自主神经功能的影响及其机制  

Effect of blood glucose fluctuation on cardiovascular autonomic neuropathy in diabetic rats

作　　者：李婉媚[1] 杨旭斌[2] 黄懿文 陈雪雁 LI Wanmei;YANG Xubin;HUANG Yiwen;CHEN Xueyan(Department of Endocrinology,the Guangzhou Twelfth People′s Hos-pital,Guangzhou 510620,China;不详)

机构地区：[1]广州市第十二人民医院内分泌内科,广州510620 [2]中山大学附属第三医院内分泌与代谢病学科,广州510630

出　　处：《实用医学杂志》2021年第16期2065-2068,2074,共5页The Journal of Practical Medicine

基　　金：2018年广东省科技创新战略专项资金(基础与应用基础研究方向)(编号:2018A030313915)。

摘　　要：目的探讨血糖波动对糖尿病大鼠心脏自主神经功能的神经营养因子、炎性因子以及乙酰胆碱酶转移酶(CHAT)、酪氨酸氢化酶(TH)、TH/CHAT水平的影响以及相关机制。方法取45只SD大鼠,其中15只为空白对照组(NC),另外30只大鼠通过STZ法制备糖尿病模型,之后将其随机分为持续高血糖组(DS)和波动高血糖组(DF)两组,各15只。其中DF组每天定时葡萄糖灌胃和胰岛素注射,DS组和NC组每天相应时间给予等量生理盐水。维持4周以后,比较各组大鼠心脏自主神经的神经营养因子、炎性因子以及CHAT、TH、TH/CHAT水平差异。结果喂养4周后,与NC组相比,DS组和DF组大鼠糖化血红蛋白更高(P<0.05),心脏自主神经匀浆液TH、TH/CHAT、神经生长相关蛋白(GAP⁃43)、神经生长因子(NGF)以及肿瘤坏死因子(TNF⁃α)、白细胞介素6(IL⁃6)、白细胞介素1β(IL⁃1β)水平明显升高,CHAT、睫状生长因子(CNTF)明显降低,且除糖化血红蛋白外,DF组大鼠上述指标变化较DS组更为显著(P<0.05)。结论血糖波动可通过影响神经营养因子及炎症因子水平,引发交感⁃迷走神经紊乱,加剧大鼠心脏自主神经功能损害。Objective To explore the effects of blood glucose fluctuations on cardiovascular autonomic neuropathy in diabetic rats and related mechanism studies,as to provide references for clinical treatment.Methods 45 SD rats were observed,of which 15 were in the blank control group(NC).Remaining 30 rats were used to prepare diabetes models by STZ method and then randomly divided into two groups with equal number of rats:the persistent hyperglycemia group(DS)and the fluctuating hyperglycemia group(DF).The DF group was given regular glucose gavage and insulin injection every day,and the DS group and NC group were given the same amount of normal saline at corresponding times every day.After maintaining for 4 weeks,the differences in the levels of neurotrophic factors,inflammatory factors,CHAT,TH,and TH/CHAT in each group were compared.Results After 4 weeks of feeding,the rats in the DS group and the DF group showed a certain degree of wildness and emaciation,disordered and lackluster hair,polyuria,polydipsia and polydipsia.Moreover,compared with the DS group,the DF group rats were thinner,less active,with lower body mass and the differences were statistically significant(P<0.05).Compared with the NC group,TH,TH/CHAT,GAP⁃43,NCF,TNF⁃α,IL⁃6,IL⁃1 and TNF⁃were significantly increased in the DS group and DF group,while CHAT and CNTF levels were significantly decreased,and the above indicators were significantly improved in the DF group(P<0.05).Conclusion Blood glucose fluctuation can affect the levels of neurotrophic factors and inflammatory factors,induce sympathetic vagus nerve disorder,and aggravate the cardiovascular autonomic neuropathy in rats.

关 键 词：血糖波动 糖尿病大鼠 心脏自主神经病变 作用机制 

分 类 号：R587.2[医药卫生—内分泌] R363[医药卫生—内科学]