保留全胃、不同区段小肠转流术后GK大鼠糖代谢变化规律的研究

The change of glucose tolerance in GK rats after stomach-preserving Roux-en-Y gastric bypass surgery

目的建立保留全胃、不同区段小肠转流手术动物模型,探讨术后GK大鼠糖代谢的变化规律。方法 GK大鼠20只随机分为4组(n=5),Ⅰ组:假手术组;Ⅱ组:十二指肠转流组;Ⅲ组:空肠转流组;Ⅳ组:回肠转流组。分别于术前及术后4周行口服糖耐量试验及胰岛素耐量试验,计算胰岛素敏感指数(ISI)。结果 (1)全部GK大鼠术后均长期存活;(2)与Ⅰ组空腹血糖相比,各实验组术后空腹血糖明显下降;(3)与Ⅰ组血糖水平相比,各实验组在OGTT各时间点血糖水平明显下降;(4)与术前ISI相比,各实验组术后ISI增加,以Ⅲ组、Ⅳ组更为显著。结论成功建立保留全胃、不同区段小肠转流手术的GK大鼠模型;GBP效应区域是回肠;术后GK大鼠糖代谢改善与胰岛素敏感性增加有关,与胃容积无关。

Objective To establish the stomach-preserving Roux-en-Y gastric bypass model in GK rats and investigate the changes in glucose tolerance after surgery. Methods 20 male GK rats were randomly divided into 4 groups： group Ⅰ （shame group）, group Ⅱ （duodenal bypass）, groupⅢ （duodenaljejunal bypass） , group Ⅳ （duodenal-ileal bypass）. OGTT and insulin tolerance test were performed before and fourth weeks after surgery and insulin sensitive index （ISI） was calculated. Results All experimental rats survived after the operation. Compared with group Ⅰ , groups of Ⅱ , Ⅲ and Ⅳ showed that fasting blood glucose level after surgery decreased significantly （all P〈 0. 01）. The OGTT blood glucose values dropped obviously at each time points after surgery. Compared with pre-operation, ISI index increased after surgery, especially in group Ⅲ and group Ⅳ. Conclusions The stomach-preserving Roux-en-Y gastric bypass model is established in GK rats. The effect of gastric bypass on blood glucose happens in ileum. The improvement of glucose metabolism is associated with the increase of ISI.