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  • 黄盛,檀建勇,戴露倢,邓治洲,邹忠东,王瑜*,王瑜.两种外科手术治疗大鼠非肥胖2型糖尿病的疗效对比[J].第二军医大学学报,2011,32(2):187-190    [点击复制]
  • HUANG Sheng, TAN Jian-yong, DAI Lu-jie, DENG Zhi-zhou, ZOU Zhong-dong, WANG Yu*,WANG YU.Efficacy comparison between two kinds of gastric bypass surgery for non-obese type 2 diabetes mellitus in rats[J].Acad J Sec Mil Med Univ,2011,32(2):187-190   [点击复制]
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两种外科手术治疗大鼠非肥胖2型糖尿病的疗效对比
黄盛,檀建勇,戴露倢,邓治洲,邹忠东,王瑜*,王瑜
0
(南京军区福州总医院普通外科,福州 350025)
摘要:
\[摘要\]目的对比Roux-en-Y胃转流术及胆胰分流术治疗大鼠非肥胖2型糖尿病的疗效。方法48只雄性Goto-Kakizaki (GK) 大鼠随机分为Roux-en-Y胃转流术(Roux-en-Y gastric bypass,RYGBP)、胆胰分流术(billiopancreatic diversion,BPD)和假手术组,每组16只。检测术前及术后1、3、6、9、12、24周空腹血糖、胰岛素水平,检测术前及术后6、12、24周糖化血红蛋白,计算胰岛素抵抗指数(HOMA-IR),观察术后各组死亡率和并发症。结果术后1~24周Roux-en-Y胃转流术、胆胰分流术组空腹血糖显著降低(P<0.05,P<0.01),术后12、24周糖化血红蛋白显著降低(P<0.01);假手术组上述指标均未见显著变化。各组空腹胰岛素水平差异无统计学意义。与术前相比,Roux-en-Y胃转流术组和胆胰分流术组术后1~24周HOMA-IR指数显著降低(P<0.05);同时间点两组间比较,术后1~24周胆胰分流术组HOMA-IR指数显著低于Roux-en-Y胃转流术组(P<0.05)。Roux-en-Y胃转流术组死亡率为6%,胆胰分流术组死亡率达50%,胆胰分流术组术后并发症及死亡率均高于Roux-en-Y胃转流术组(P<0.05)。结论Roux-en-Y和胆胰分流术治疗大鼠非肥胖2型糖尿病疗效相近,但胆胰分流术术后并发症和死亡率高于Roux-en-Y胃转流术。
关键词:  2型糖尿病  胃转流术  胆胰分流术  Roux-en-Y吻合术
DOI:10.3724/SP.J.1008.2011.0187
投稿时间:2010-07-22修订日期:2011-01-21
基金项目:福建省重点科技计划项目(2009Y0039),南京军区医学科技创新重点项目(09Z031).
Efficacy comparison between two kinds of gastric bypass surgery for non-obese type 2 diabetes mellitus in rats
HUANG Sheng, TAN Jian-yong, DAI Lu-jie, DENG Zhi-zhou, ZOU Zhong-dong, WANG Yu*,WANG YU
(Department of General Surgery, Fuzhou General Hospital, PLA Nanjing Military Area Command, Fuzhou 350025, Fujian, China)
Abstract:
\[Abstract\]ObjectiveTo compare the efficacies of Roux-en-Y gastric bypass (RYGBP) and billiopancreatic diversion(BPD) in treatment of rats with non-obese type 2 diabetes mellitus. MethodsTotally 48 Goto-Kakizaki rats were randomized to undergo one of the following procedures: Roux-en-Y gastric bypass(n=16), biliopancreatic diversion(n=16), and sham operation (n=16). The fasting blood glucose and fasting insulin were determined before and 1, 3, 6, 9, 12, and 24 weeks after operation; the hematoglobin A1c (HbA1c) levels were determined before and 6, 12, and 24 weeks after operation and the insulin resistance index (HOMA-IR) was calculated. The mortality and complications were observed in each group. ResultsThe fasting blood glucose levels were significantly decreased during 1-24 weeks after operation in both Roux-en-Y group and biliopancreatic diversion group(P<0.01 or P<0.05); the HbA1c levels were also decreased 12 and 24 weeks after operation (P<0.01); and the above parameters were not significantly changed in the sham operation group. The fasting insulin levels were not significantly different between the 3 groups. In RYGBP group and the BPD group, the HOMA-IR indices decreased significantly 1-24 weeks after operation compared with those before operation (P<0.05), and those in the BPD group were significantly lower than those in the RYGBP group at all time points (P<0.05). The mortality was 6% in the RYGBP group and 50% in the BPD group. The complication rate and mortality in the BPD group were significantly higher than those in the RYGBP group (P<0.05). ConclusionRYGBP and BPD have similar efficacies in treatment of rats with non-obese type 2 diabetes mellitus, and BPD can lead to higher incidences of complications and mortalities than RYGBP.
Key words:  type 2 diabetes mellitus  gastric bypass  billiopancreatic diversion  Roux-en-Y anastomosis