胃束带术和袖状胃切除术对营养性肥胖大鼠干预效果差异的研究

The different effects of gastric banding and sleeve gastrectomy on obese rat

目的探讨胃束带术（GB）和袖状胃切除术（SG）对营养性肥胖大鼠疗效的差异。方法对饮食诱导方法建立的大鼠肥胖模型分别实施GB、SG和对照组（SO），于术后14、28和56d比较手术对肥胖大鼠进食量、体重、血脂和某些脂源性激素的影响。结果喂养7周后，高脂饮食组31只达成模标准。成模率88．6％（31／35）。术后56d，GB和SG组总进食量均低于SO组（P〈0．01）；GB和SG组术后总进食量相比差异无统计学意义（P〉0．05）。GB、SG和SO组体重分别为（609．1±6．0）g、（591．6±4．3）g和（649．8±10．0）g，差异有统计学意义（P〈0．01）。SG对TC、TG、FFA、LDL—c和HDL—c的改善程度均较GB明显，差异有统计学意义（P〈0．05）。术后SG和GB组饥饿素（ghrelin）水平呈持续下降趋势，但SG组降低更加明显。至术后56d，GB和SG组ghrelin水平分别由术前的（1151．0±144．2）pg／ml和（1148．2±127．2）pg／ml降低至（992．0±121．9）pg／ml（P〈0．05）和（761．0±125．3）pg／ml（P〈0．01）。术后GB和SG组瘦素（leptin）水平均持续下降，于术后56d明显，差异有统计学意义（P〈0．05）。结论术后总进食量SG和GB组无明显差异，SG在控制体重增加、改善血脂方面优于GB。GB和SG对大鼠ghrelin和leptin的影响明显不同可能是2种手术对大鼠疗效差异的重要原因。

Objective To evaluate the different effects of gastric banding （GB） and sleeve gastrectomy （SG） on diet-induced obese rat model. Methods The obese rat model was established via the diet-lnduced method, and then underwent SG, GB, or sham-operation （SO） procedures. The different effects of SG, GB, and SO on these rats were evaluated at the 14th, 28th and 56th day after operation. Results After 7 weeks＇ feeding, 31 rats in high-diet group reached the modeling standard. The model success rate was 88.6% （31/35）. GB and SG group showed significantly less cumulative food intake than SO group （ P 〈 0. 01 ）. There was no significant difference between GB and SG group in cumulative food intake （ P 〉 0. 05 ）. The average weight of rats in GB and SG group was （609. 1 ± 6. 0 ） g and （ 591.6 ± 4. 3 ） g respectively at the 56th day after operation while it was （649. 8 ± 10. 0） g for SO group. The difference had statistical significance （P 〈0. 01 ）. SG group showed better improvement effects on TC, TG, FFA, LDL-e and HDL-c than GB group （P 〈 0. 05）. The postoperative ghrelin level in GB and SG group all decreased constantly and it decreased slower in GB group than in SG group. At the 56th day after operation, the ghrelin level in GB and SG group reduced from （1 151.0 ± 144. 2） pg/ml and （ 1 148.2 ± 127.2） pg/ml to （992. 0 ± 121.9） pg/ml （ P 〈 0. 05） and （761.0 ± 125.3 ） pg/ml （P 〈 0. 01 ） respectively. The leptin level in GB and SG group all showed decreasing tendency. However, the leptin level of the 2 groups presented significant difference at the 56th day after operation. Conclusions There is no significant difference between GB and SG group in postoperative cumulative food intake. However, SG has better effects on controlling weight gain and improving blood lipids than GB. The different effects of GB and SG on the level of ghrelin and leptin in rats may account for the different curative effects.