摘要
目的探讨防反流的改良型十二指肠旷置术对2型糖尿病(type 2 diabetes mellitus,T2DM)大鼠糖代谢的影响,明确十二指肠在维持葡萄糖稳态中的作用。方法取40只5周龄的雄性SD大鼠,通过高脂饲料喂养联合低剂量链脲霉素诱导T2DM。将36只达到T2DM模型标准的大鼠随机分为3组:单纯十二指肠旷置术组(DE组)、防反流的改良型十二指肠旷置术组(MDE组)及假手术组(SO组),每组12只。术后第4周行胃肠道造影,并分别于术前及术后1、2、4、8周检测各组大鼠的体重、空腹血糖浓度、血清胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)浓度;术后8周处死大鼠,取每组大鼠胆胰袢1 cm肠段,行病理切片的苏木精-伊红(hematoxylin and eosin,HE)染色后在光学显微镜下观察肠黏膜绒毛长度。结果胃肠造影显示DE组中造影剂明显向十二指肠肠腔反流,而MDE组未见反流现象。术后1周,3组大鼠的体重较术前均短暂性显著下降(P<0.05),之后各组大鼠体重均随时间增长,组间体重无显著差异(P>0.05)。与SO组比较,MDE组和DE组术后各个时间点的空腹血糖浓度明显下降(P<0.05),GLP-1浓度显著升高(P<0.05);MDE组术后各个时间点的空腹血糖浓度均比DE组低(P<0.05),但MDE组和DE组之间术后各个时间点的血清GLP-1浓度无显著差异(P>0.05)。在肠黏膜形态学上,MDE组大鼠的胆胰袢黏膜绒毛长度均明显短于DE组和SO组(P<0.05)。结论防反流的改良型十二指肠旷置术可以有效改善T2DM大鼠的糖代谢,避免食糜向旷置的十二指肠反流,从而加强其降糖作用。
Objective To investigate the impact of anti-reflux modified duodenal exclusion surgery on glucose metabolism in rats with type 2 diabetes mellitus(T2DM),and to elucidate the role of the duodenum in maintaining glucose homeostasis.Methods Forty male Sprague-Dawley rats aged 5 weeks were fed a high-fat diet and induced with T2DM using low-dose streptozotocin.Thirty-six rats that met the T2DM model criteria were randomly divided into three groups:the simple duodenal exclusion surgery group(DE group),the anti-reflux modified duodenal exclusion group(MDE group),and the sham operation group(SO group),with 12 rats in each group.Gastroenterography was performed 4 weeks after surgery,and the body weight,fasting blood glucose levels,and serum glucagon-like peptide-1(GLP-1)concentrations were measured before surgery and at 1,2,4,and 8 weeks post-surgery.Eight weeks post-surgery,the rats were euthanized,and a 1 cm segment of the biliopancreatic loop was collected from each group for pathological sectioning and HE staining to observe the intestinal mucosal villus length under an optical microscope.Results Gastroenterography showed that there was significant reflux of the contrast agent into the duodenal lumen in the DE group,while no reflux was observed in the MDE group.At one week postsurgery,the body weights of rats in all three groups significantly decreased compared to before surgery(P<0.05),and then the body weights of all groups increased over time,with no significant differences between the groups(P>0.05).Compared with the SO group,the fasting blood glucose levels in the MDE and DE groups significantly decreased at all time points post-surgery(P<0.05),while GLP-1 concentrations significantly increased(P<0.05).The fasting blood glucose levels in the MDE group were lower than those in the DE group at all time points post-surgery(P<0.05),but there were no significant differences in serum GLP-1 concentrations between the MDE and DE groups(P>0.05).Regarding intestinal mucosal morphology,the villus lengths of the biliopancreatic loops in the MDE group were significantly shorter than those in the DE and SO groups(P<0.05).Conclusion Anti-reflux modified duodenal exclusion surgery effectively improves glucose metabolism in T2DM rats by preventing the reflux of chyme into the diverted duodenum,thereby enhancing its hypoglycemic effect.
作者
杨劲
俞诗雅
林楠
方永超
赵虎
邱锦维
林鸿铭
陈惠燕
王瑜
吴伟航
YANG Jin;YU Shiya;LIN Nan;FANG Yongchao;ZHAO Hu;QIU Jinwei;LIN Hongming;CHEN Huiyan;WANG Yu;WU Weihang(Department of General Surgery,900th Hospital of Joint Logistics Support Force,PLA,Fuzhou 350000,China;Fuzong Clinical Medical College,Fujian Medical University,Fuzhou 350000,China)
出处
《实验动物与比较医学》
CAS
2024年第5期523-530,共8页
Laboratory Animal and Comparative Medicine
关键词
十二指肠旷置术
2型糖尿病
血糖
胃肠造影
肠绒毛
大鼠
Duodenal exclusion surgery
Type 2 diabetes mellitus
Blood glucose
Gastroenterography
Intestinal villi
Rats
