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胃旁路术及迷走神经肝支对2型糖尿病大鼠降糖效果的影响
张勤,李肖珂,裘年存,宋鑫,仇明,单成祥*
0
(第二军医大学长征医院普通外科, 上海 200003*通信作者)
摘要:
目的 观察Roux-en-Y胃旁路术(Roux-en-Y gastric bypass,RYGB)及迷走神经肝支对2型糖尿病大鼠降糖效果及空腹血清胰高血糖素样肽-1(GLP-1)的影响及交互作用。方法 将45只2型糖尿病建模成功大鼠分成假手术组(S组,n=10)、假手术+迷走神经肝支切断组(SV组,n=11)、RYGB组(n=12)、RYGB 迷走神经肝支切断组(RYGBV组,n=12)。检测术前及术后各组大鼠体质量、空腹血糖、空腹血浆胰岛素、空腹血清GLP-1,分析RYGB和迷走神经肝支对空腹血清GLP-1的影响。结果 与S组、RYGBV组比较,RYGB 组的2型糖尿病大鼠体质量下降(P<0.05),空腹血清GLP-1和胰岛素水平提高(P<0.05);RYGB组大鼠空腹血糖水平较S组降低(P<0.05),与RYGBV组比较差异无统计学意义。RYGB对空腹血清GLP-1影响的主效应大于迷走神经肝支,两者存在交互作用(P<0.05)。结论 RYGB对2型糖尿病具有较好的治疗效果,RYGB术中应当注意保护迷走神经肝支。
关键词:  迷走神经肝支  胃旁路术  2型糖尿病  胰高血糖素样肽-1
DOI:10.3724/SP.J.1008.2014.00938
投稿时间:2014-03-04修订日期:2014-07-19
基金项目:
Impact of gastric bypass treatment and hepatic branch of the vagus on hypoglycemic outcome in rats with type 2 diabetes
ZHANG Qin,LI Xiao-ke,QIU Nian-cun,SONG Xin,QIU Ming,SHAN Cheng-xiang*
(Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
* Corresponding author.)
Abstract:
Objective To observe the effect of Roux-en-Y gastric bypass (RYGB) treatment and hepatic branch of the vagus on hypoglycemic outcome and glucagon-like peptide-1(GLP-1) in rats with type 2 diabetes, and the interaction of between the two. Methods Totally 45 type 2 diabetic rats were divided into four groups: sham operation (S group, n=10), sham operation with hepatic branch of the vagus resected (SV group, n=11), RYGB group (n=12), and RYGB with hepatic branch of the vagus resected (RYGBV group, n=12). The body mass, fasting blood-glucose (FBG), fasting serum insulin (FINS) and concentrations of fasting serum GLP-1 were examined before and after surgery. Effects of RYGB and the hepatic branch of the vagus on GLP-1 levels were analyzed. Results Compared with S group and RYGBV group, RYGB group had significantly decreased body mass(P<0.05) and significantly improved levels of serum GLP-1 and insulin (P<0.05); FBG level in RYGB group was significantly lower than that in S group (P<0.05) and similar to that in RYGBV group. The effect of RYGB on fasting serum GLP-1 was stronger than that of liver branch of the vagus nerve, and there was interaction between the two (P<0.05). Conclusion RYGB treatment has satisfactory treatment effect for type 2 diabetes, and care should be taken during RYGB surgery to preserve the hepatic branch of the vagus.
Key words:  hepatic branch of the vagus  gastric bypass  type 2 diabetes  glucagon-like peptide-1