袖状胃切除治疗大鼠2型糖尿病的作用机制研究.PDFVIP

袖状胃切除治疗大鼠2 型糖尿病的作用机制研究 * 刘凤恩， 志勇 ，段训洪，黄文祯，赖闺娥，易坚 （赣南医学院第一附属医院 血管乳腺科，江西 赣州 341000 ） 江西省科技厅科技支撑计划，编号：2009BSA 11200 *通讯作者：刘志勇，男，主治医师。E-mail:barton123321@163.com 摘要：目的：探讨袖状胃切除术治疗2型糖尿病的作用及机制。方法：肥胖大鼠注射链脲佐 菌素(Streptozoein，STZ)建立2型糖尿病大鼠模型，然后随机分为袖状胃切除手术组(SG组) ， 正常组(NG组)和假手术组(SS组) 。观察比较3组大鼠术后体重、摄食量、糖耐量、空腹胰岛 素、胰岛素敏感指数及空腹Ghrelin，GLP-1浓度的变化。RT-PCR测定胰腺内胰岛素mRNA表达 水平，免疫组化染色观察胰岛 细胞形态学特点，用彩色图像分析系统进行定量比较。结果： SG组大鼠术后体重连续3周持续下降，术后摄食量显著减少(P0.05) 。术后8周手术组糖耐量 显著改善。手术组术后血清Ghrelin下降，GLP-1升高，空腹胰岛素（FINS ）下降，胰岛素敏 感指数升高，均具有显著统计学意义 （P0.001）。SG组与NG组相比较，其 细胞光密度值、 细胞面积比、胰岛素mRNA均显著降低，均具有显著统计学意义 （P0.001）。结论：2型糖 尿病大鼠胃袖状切除后术后摄食减少不是导致血糖改善的唯一原因。术后空腹胰岛素浓度降 低、胰岛素敏感性改善；术后Ghrelin水平下降、GLP-1水平上升是治疗2型糖尿病机制之一。 关键词：袖状胃切除；2 型糖尿病；Ghrelin；GLP- 1 Effects and mechanism of sleeve gastrectomy on type 2 diabetes mellitus LI U Feng-en, LI U Zhi-y ong, DUAN X un-hong, H UAN G Wen-zheng, LAI Gui-e, YI Jing. The fi rst affili ated hosp ital of GanNan medical university, Dep artment of Vascular Breast Surgery, ganzhou, 341000） Abstract: Objective:Explore the effeet and meehanisms in relieving type 2 diabetes mellitus after Sleeve Gastreetomy.Methods:To establish a type 2 diabetes mellitus animal model,the obese rats were inj ected with STZ，then followed to distribution into SG group, normal group(NG) group and sham-surgery(SS)group.Afters consecutive observation, comparisons were scaled in weight loss,diet intake, differences in fast glucose，insulin，insulin resistance index and concentration of Ghrelin,GLP-1.Insulin mRNA was detected by RT-PCR. Morphologic changes of islet cells stained by immunohistochemistry were analyzed and quantified with a color image analyzer. Results: SG group rats weight after declining for 3 consecutive weeks; SG group rats food intake was significantly reduced after postoperative (P0.05). All time points after surgery, SG group glucose tole