袖状胃切除术与胃旁路术治疗GK大鼠疗效的比较研究

Efficacy comparison in GK rats between sleeve gastrectomy and Roux-en-Y gastric bypass

目的:对比袖状胃切除术与胃旁路术治疗大鼠非肥胖2型糖尿病的疗效。方法:30只GK大鼠随机分为袖状胃切除术组(SG组)、胃旁路术组(RYGB组)、假手术组(SO组),每组10只。观察术后各组存活情况,并根据情况检测各组术前及术后第1、4、8周的体质量、空腹血糖、口服糖耐量试验峰值、糖化血红蛋白比值及血清胰岛素水平。结果:SG组大鼠手术存活率100%,RYGB组手术存活率90%,SO组大鼠全部健康存活,3组手术存活率比较差异无统计学意义(P=0.305)。术后8周时,各组体质量均超过术前,RYGB组明显低于SO组和SG组(P<0.05)。空腹血糖在SG组和RYGB组术后第1周即有下降趋势,术后8周时SG组较SO组降低,差异有统计学意义(P<0.05),RYGB组较SO组明显降低(P<0.01),RYGB组与SG组比较差异亦有统计学意义(P<0.05)。口服糖耐量试验峰值在SG组和RYGB组术后1周即有下降,术后8周时SG组较SO组虽有降低但差异无统计学意义(P<0.05),RYGB组较SO组明显降低(P<0.01)。术前各组糖化血红蛋白比值差异无统计学意义,术后8周时SG组较SO组降低(P<0.05),RYGB组较SO组明显降低(P<0.01),RYGB组与SG组差异亦有统计学意义(P<0.05)。8周后胰岛素水平SO组与SG组比较差异无统计学意义(P>0.05),RYGB组在8周后升高明显,与前2组比较差异具有统计学意义(P<0.05)。结论:袖状胃切除术与胃旁路术术后存活率相近,但胃旁路术治疗GK大鼠的疗效优于袖状胃切除术。

Objective： To compare the efficacies of sleeve gastrectomy and Roux-en-Y gastric bypass in treatment of rats with non-obese type 2 diabetes mellitus. Methods： 30 GK rats were randomly divided into Sleeve gastrectomy group, Roux-en-Y gastric bypass group and sham-operation group. To observe the postoperative group survival rate and preoperative body weight, FPG, HbAlc, OGTT, the level of serum INS were compared with that on 1, 4, 8 weeks after operation. Resuits： SG group rats survival rate 100%, gastric bypass surgery operative survival rate 90%, control group rats live healthy, atl three groups survival rate comparing with no statistical significance （P=0. 305）. At 8 weeks postoperatively, each body quality than preoperative, gastric bypass surgery group were significantly lower than the control group and sleeve gastrectomy group（P〈0.05）. Fasting plasma glucose and oral glucose tolerance test peak, glycosylated hemoglobin ratio in the sleeve gastrectomy group and gastric bypass surgery postoperative week 1 that there was a downturn in the postoperative 8 weeks sleeve gastrectomy group to reduce the difference was statistically significant（P〈0.05）, gastric bypass surgery group significantly decreased（P〈0.01）, of which the gastric bypass surgery and the sleeve gastrectomy group comparative differences were statistically significant （P〈0.05）. After 8 weeks INS level control and sleeve gastrectomy group there was no statistical significance（P〉0.05）, gastric bypass surgery group increased obviously after 8 weeks, compared with the former two groups have statistical significance （P〈0.05）. Conclusions： SG and RYGB have similar survival rate, but the curative effect of gastric bypass surgery GK rats is superior to the sleeve gastrectomy.