Roux—en—Y胃旁路术对糖尿病大鼠肾脏的保护作用

Protective effect of Roux-en-Y gastric bypass on kidney in diabetic Goto-Kakizaki rats

目的观察Roux—en—Y胃旁路术对糖尿病Goto．Kakizaki（GK）大鼠肾脏的保护作用。方法18只GK大鼠随机等分为Roux-en-Y胃旁路手术组（RYGP组）、假RYGP组和对照组；观察手术前、手术后12周各组大鼠血清血栓素（TXB2）、6-酮-前列环素（6-kET-lo-PGFla）、内皮素-1（ET-1）、尿素氮（sCr）、肌酐（BUN）和24h尿蛋白（24huPro）含量；手术后12周苏木素-伊红（HE）染色观察大鼠肾脏病理变化。结果手术前3组大鼠各检测指标差异无统计学意义（P〉0．05）。与手术前比较，手术后12周，假RYGP组大鼠TXB2（66．31±6．13）ng／L比（101．424-9．70）ng／L、ET-1（58．31±5．32）．g／L比（79．01±6．89）ng／L、sCr（48．78±3．66）p,mol／L比（70．33±6．21）p,mol／L、BUN（5．41±0．68）mmol／L比（8．35±0．92）mmol／L和24huPro（0．44±0．10）g／24h比（0．86±0．17）g／24h均显著升高，6-kET-lo—PGFla（85．72±6．87）ng／L比（60．41±8．23）ng／L显著降低，差异均有统计学意义（P〈0．05）；对照组与假RYGP组一样获得相似的结果；RYGP组大鼠各检测指标变化差异无统计学意义（P〉0．05）。手术后12周，RYGP组与假RYGP组比较TXB2（72．31±7．56）ng／L比（101．42±9．70）ns／L、ET-1（62．11±6．26）ng/L比（79．01±6．89）ng／L、sCr（54．36±4．12）μmol／L比（70．33±6．21）μmol／L、BUN（5．71±0．86）mmol／L比（8．35±0．92）mmoL／L、24huPro（0．52±0．10）g／24h比（0．86±0．17）g／24h和6．kET-lo-PGFla（83．22±5．62）．g／L比（60．41±8．23）ng／L差异均有统计学意义（P〈0．05）；RYGP组与对照组比较，各检测指标差异均有统计学意义（P〈0．05）；假RYGP组、对照组血清TXB2与6-kET-lo-PGFla呈显著负相关，与ET-1呈显著正相关（P〈0．05）。手术后12周，假RYGP组和对照组大鼠肾脏有明显病理性损害；RYGP组大鼠肾脏病理变化不明显。结论Roux-en-Y胃旁路术对GK大鼠肾脏具有保护作用。

Objective To observe the protective effects of Roux-en-Y gastric bypass on the kidney in Goto-Kakizaki （GK） diabetic rats. Methods Eighteen male GK rats were randomly divided into Roux- en-Y gastric bypass group （RYGP）, sham RYGP group （sham-RYGP） and pair-fed control group. Before and 12 weeks after operation, the values of serum thromboxane B2 （TXB2）, 6-kET-lo-taglandine Ia （6-kET-lo-PGFla）, endothelin-1 （ ET-1 ）, serum creatinine （ sCr）, blood urea nitrogen （ BUN）, and 24-h urine protein （24-h uPro） were measured, and the pathological changes of the kidney were analyzed 12 weeks after operation. Results No significant differences were observed in pre-operative values （P 〉 0. 05） among three groups. In sham-RYGP group, levels measured before and 12 weeks after operation were as follows： TXB2 （66.31 ±6. 13） ng/L vs. （101.42 ±9.70） ng/L, ET-1 （58.31 ±5.32） ng/L vs. （79. 01 ±6. 89） ng/L, sCr （48. 78 ±3. 66） μmol/L vs. （70. 33 ±6. 21） μmol/L, BUN （5. 41 ±0. 68） mmol/L vs. （8.35 ±0.92） mmol/L and 24-h uPro （0.44 ±0. 10） g/24 h vs. （0.86 ±0.17） g/24 h （ all P 〈0. 05） ; 6-kET-lo-PGFla （85. 72±6. 87） ng/L vs. 60. 41±8.23） ng/L （P 〈0. 05）. There was significant difference between sham-RYGP group and control group （ all P 〈 0. 05 ）. There was no signifi- cant difference before and 12 weeks after operation in RYGP group （P 〉0. 05）. Between RYGP group and sham-RYGP, there were significant differences in TXB2 （72. 31 ± 7. 56） ng/L vs. （101.42 ± 9. 70） ng/L, ET-1 （62. 11±6.26） ng/L vs. （79.01±6.89） ng/L, sCr （54.36±4. 12） μmol/L vs. （70.33 ± 6.21） ixmoL/L, BUN （5.71 ±0.86） mmol/L vs. （8.35 ±0.92） mmol/L, 24-h uPro （0.52 ±0. 10）g/24 h vs. （0. 86±0. 17） g/24 h and 6-kET-lo-PGFla （83.22±5.62） ng/L vs. （60. 41±8. 23） ng/L at 12th week after operation （ all P 〈 0. 05 ）, as well as between RYGP group and control group. On the post-operative week 12, serum TXB2 level was positively related with ET-1 level, but negatively with 6- kET-lo-PGF1 a in sham-RYGP and control group （P 〈 0.05 ）, On the post-operative week 12, pathologic lesions were observed on the kidney of GK rats in sham-RYGP and control groups, but there was no obvious pathologi lesions of the kidney in RYGP group, Conclusion Roux-en-Y gastric bypass can protect the kid- ney in diabetic GK rats.