CAJ | 학술논문

目的观察不同胃肠吻合方式对非肥胖型2型糖尿病(T2DM)大鼠的治疗作用.方法将24只雄性Goto-Kakizaki(GK)大鼠随机分3组,分别为Roux-en-Y式、毕Ⅱ式胃转流术组和毕Ⅰ式组,每组8只.检测术前(0周)及术后1、3、6、12、24周空腹血糖及空腹血清胰岛素水平,采用稳态模型法计算胰岛素抵抗指数(HOMA-IR).结果与术前比较,毕Ⅰ式组空腹血糖、空腹胰岛素、HOMA-IR术后1～24周未见明显变化(P＞0.05):而Roux-en-Y式、毕Ⅱ式组术后1～24周空腹血糖较术前显著降低(P＜0.01),术后24周,空腹血糖由(12.56±2.97)、(12.96±3.01)mmol/L下降到(7.87±0.75)、(9.21±1.53)mmol/L;空腹胰岛素术后1～24周未见明显变化(P＞0.05),HOMA-IR术后1～24周显著降低(P＜0.01),术后24周,HOMA-IR由(11.92±1.45)、(12.69±2.03)下降到(6.66±1.25)、(7.97±0.68).结论毕Ⅰ式胃肠吻合术对2型糖尿病大鼠可能无治疗作用,Roux-en-Y式和毕Ⅱ式胃转流术可改善2型糖尿病大鼠胰岛素抵抗程度,有效控制血糖水平,且Roux-en-Y式胃转流术疗效优于毕Ⅱ式胃转流术.
목적 관찰불동위장문합방식대비비반형2형당뇨병(T2DM)대서적치료작용.방법 장24지웅성Goto-Kakizaki(GK)대서수궤분3조,분별위Roux-en-Y식、필Ⅱ식위전류술조화필Ⅰ식조,매조8지.검측술전(0주)급술후1、3、6、12、24주공복혈당급공복혈청이도소수평,채용은태모형법계산이도소저항지수(HOMA-IR).결과 여술전비교,필Ⅰ식조공복혈당、공복이도소、HOMA-IR술후1～24주미견명현변화(P＞0.05):이Roux-en-Y식、필Ⅱ식조술후1～24주공복혈당교술전현저강저(P＜0.01),술후24주,공복혈당유(12.56±2.97)、(12.96±3.01)mmol/L하강도(7.87±0.75)、(9.21±1.53)mmol/L;공복이도소술후1～24주미견명현변화(P＞0.05),HOMA-IR술후1～24주현저강저(P＜0.01),술후24주,HOMA-IR유(11.92±1.45)、(12.69±2.03)하강도(6.66±1.25)、(7.97±0.68).결론 필Ⅰ식위장문합술대2형당뇨병대서가능무치료작용,Roux-en-Y식화필Ⅱ식위전류술가개선2형당뇨병대서이도소저항정도,유효공제혈당수평,차Roux-en-Y식위전류술료효우우필Ⅱ식위전류술.
Objective To investigate the effect after gastrojejunostomy with different types of anastomosis in an animal model of nonobese type 2 diabetes.Methods Twenty-four Goto-Kakizaki rats randomly underwent one of the following procedures:gastric bypass with different types of anastomosis of Roux-en-Y ( n = 8),Billroth Ⅱ ( n = 8 ) or Billroth Ⅰ ( n = 8 ).Rats were observed for 24 weeks after surgery.Fasting blood glucose and insulin level were tested at 0,1,3,6,12,24 weeks and homeostasis model assessment of insulin resistance (HOMA-IR) was done.Results As compared with preoperation,fasting blood glucose levels,the fasting blood insulin level and the HOMA-IR level had no significant change in Billroth Ⅰ rats during the entire follow-up period ( P ＞ 0.05).In both Roux-en-Y and Billroth Ⅱ groups,fasting blood glucose levels were significantly decreased as early as 1 week after surgery and then kept a similar level during the entire follow-up period (P＜0.01 ).Twenty-four weeks after operation,the fasting blood glucose levels was declined from (12.56 ±2.97),(12.96 ±3.01) mmol/L to (7.87 ±0.75),(9.21 ± 1.53) mmol/L;the fasting blood insulin levels were similar during the entire follow-up period ( P ＞0.05 ).The HOMA-IR level was significantly decreased after surgery in both Roux-en-Y and Billroth Ⅱ groups during the follow-up period ( P＜0.01 ).Twenty-four weeks after operation,the HOMA-IR level was declined from (11.92 ± 1.45),(12.69 ±2.03) to (6.66 ± 1.25),(7.97 ±0.68).Conclusion Billroth Ⅰ reconstruction after gastrectomy is not effective on diabetes control.Roux-en-Y and Billroth Ⅱ gastric bypass in a nonobese diabetic model were effective in terms of glucose control and improving insulin resistance.But Roux-en-Y gastric bypass seems to be more effective than Billroth Ⅱ gastric bypass on antidiabetes.