CAJ | 학술논문

目的研究胃旁路术（GBP）对糖尿病大鼠血糖的控制效果以及对胰岛细胞的影响。方法采用链脲佐菌素建立糖尿病SD大鼠模型（20只），随机分为糖尿病手术组（DO组）和糖尿病对照组（DC组），另取20只非糖尿病大鼠随机分为正常手术组（NO组）和正常对照组（NC组）。DO组和NO组大鼠行GBP，DC组和NC组大鼠行假手术，分别检测各组大鼠术前、术后72h，1、4和8周空腹血糖水平。术后8周，取胰腺组织行HE染色和免疫荧光检查，观察组织学变化。结果术前DO组与DC组以及NC组与NO组大鼠空腹血糖均无统计学差异（均P＞0.05）。DO组大鼠术后空腹血糖进行性下降（均P＜0.05）。DC组大鼠术前及术后各时相空腹血糖无统计学差异（均P＞0.05）；NO组和NC组大鼠组内不同时相以及组间相同时相空腹血糖比较均无统计学差异（均P＞0.05）。HE染色提示手术组大鼠胰腺内出现新生小胰岛，大部分出现在胰管周围且结构接近正常胰岛；免疫荧光显示胰岛数目增加，胰岛素免疫荧光发现较多孤立的及由二、三个胰岛素阳性细胞组成的小胰岛。胰岛素和胰高血糖素免疫荧光双标提示部分胰岛内存在胰岛素和胰高血糖素双阳性细胞。结论 GBP对2型糖尿病大鼠具有明显的降糖作用，胰岛再生在其中起着重要作用，但对正常大鼠血糖无影响。
목적연구위방로술（GBP）대당뇨병대서혈당적공제효과이급대이도세포적영향。방법채용련뇨좌균소건립당뇨병SD대서모형（20지），수궤분위당뇨병수술조（DO조）화당뇨병대조조（DC조），령취20지비당뇨병대서수궤분위정상수술조（NO조）화정상대조조（NC조）。DO조화NO조대서행GBP，DC조화NC조대서행가수술，분별검측각조대서술전、술후72h，1、4화8주공복혈당수평。술후8주，취이선조직행HE염색화면역형광검사，관찰조직학변화。결과술전DO조여DC조이급NC조여NO조대서공복혈당균무통계학차이（균P＞0.05）。DO조대서술후공복혈당진행성하강（균P＜0.05）。DC조대서술전급술후각시상공복혈당무통계학차이（균P＞0.05）；NO조화NC조대서조내불동시상이급조간상동시상공복혈당비교균무통계학차이（균P＞0.05）。HE염색제시수술조대서이선내출현신생소이도，대부분출현재이관주위차결구접근정상이도；면역형광현시이도수목증가，이도소면역형광발현교다고립적급유이、삼개이도소양성세포조성적소이도。이도소화이고혈당소면역형광쌍표제시부분이도내존재이도소화이고혈당소쌍양성세포。결론 GBP대2형당뇨병대서구유명현적강당작용，이도재생재기중기착중요작용，단대정상대서혈당무영향。
Objective To investigate the influence of gastric bypass surgery on fasting blood- glucose (FBG) levels in type 2 diabetic rats. Methods Forty rates were randomly divided into 4 groups with 10 in each groups:type 2 diabetes mel itus were induced by injection of stretozotocin in DO and DC group, gastric bypass operation was performed in DO and NO groups and sham operation was performed in DC and NC groups. The FBG levels were determined before operation and 72h, 1, 4 and 8 weeks after operation. The tissue sections were HE- stained and examined histopathological y. Results There were no signif-icant differences in FBG levels before operation between DO and DC groups or between NO and NC groups (P>0.05). FBG levels in DO group gradual y declined after operation and were lower than those before operation (P<0.05);however, stil higher than those in NO and NC groups at the same time point (P<0.05). FBG levels in DC group were not significantly changed at al time points(P>0.05). The inter- group and intra- group differences of FPG levels in NO and NC groups were not statistical y sig-nificant(P>0.05). HE staining showed that there was regeneration of pancreas islets and the morphology was similar to the nor-mal in DO group at 8 weeks after operation. Conclusion Gastric bypass operation can reduce the FBG levels in type 2 diabetic rats, which is associated with the regeneration of pancreas islets.