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畏奎越
9 years ago
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1 绎阴元元 GBRoux-en-Y RYGBPBPD 2 T2DMSTZ T2DM 70 GB G RYGBP R BPD B 20 S BG TG TCINSISI 16 GB RYGBP BPD 依 22.5 g 依 17.5 g 依 28.4 g BG 依 1.29 mmol L 依 0.81 mmol L 依 2.39 mmol L -1 TC 2.32 依 0.45 mmol L 依 0.79 mmol L 依 0.31 mmol L -1 TG 1.38 依 0.32 mmol L 依 0.41 mmol L 依 0.35 mmol L -1 ISI 依依依 0.23 P<0.05 P<0.01RYGBP INS 依 mu L -1 P<0.05GB 5% RYGBP 20% BPD 35% GB RYGBP BPD IR 2 doi: /wst R269 A 2 iopancreatic Diversion BPD Type 2 Diabetes Mellitus T2DM [2,3] 90% T2DM T2DM 63.5% T2DM [4] BMI 逸 30 kg m -2 T2DM 50% T2DM [1] Streptozotocin STZ Gastric Banding GBRoux-en-Y Rouxen-Y Gastric Bypass RYGBPBil 原 T2DM 3 T2DM Blood Glucose BG Triglyceride TG Total Cholesterol TCIn 原元 2010B 元元 764

2 2013 绎 Vol.15 No.4 sulin INS T2DM 1. SPF SD 200 依 20 g 100 SCXK SYXK One Touch Ultra 7060 Thermo LABSYSTEMS STZ ELISA CUSABIO BIOTECHCO LTD 3. 18% 20% 3%59% SPF SD h STZ 30 mg kg -1 5 >16.7 mmol L -1 T2DM 2 4 GB G 20 RYGBP R 20 BPD B 20 S h 10% 0.3mL/100g G 1cm 1/3 20% R Treiz 8 cm 12 cm B Treiz 50 cm 10 cm S 3cm 3 24 h 24 h 16 10% BG TG TC INS ISI 4 SPSS 19.0 LSD P< GB RYGBP BPD P<0.01 RYGBP BPD GB 24 h RYGBP 24 h 2 BPD 24 h 3 GB 1 RYGBP BPD S 1 2. GB RYGBP BPD 16 P< BG GB RYGBP 2 BPD 3 BG 765

3 绎 P<0.05 P< BG 16 3 BG P<0.013 BG GB RYGBP 2 BPD 3 BG P<0.05 P<0.01 BG 16 RYGBP BG GB RYGBP P<0.05 P< TC TG GB BPD 2 RYGBP 3 TC P<0.05 P< TC P<0.01 GB 3 BPD RYGBP 4 TG P< TG P< TC TG GB BPD 3 TC TG RYGBP 2 TC 3 TG P<0.05 P<0.01 TC TG 4 5. GB BPD INS 16 GB BPD INS GB BPD INS RYGBP 16 INS P<0.05 BPD 2 GB RYGBP 8 ISI [5] 1 /min /h /% /% /% G 19.9 依依 R 44.1 依 8.3 a 43.9 依 3.7 a B 48.7 依 7.0 a 46.9 依 3.2 a G a P< x 依 s n=10 g G 依依 26.3 d 依 38.3 d 依 21.2 d 依 15.8 d 依 18.9 d 依 22.5 d R 依依 39.6 d 依 38.0 d 依 37.5 d 依 22.2 d 依 21.2 d 依 17.5 d B 依依 34.4 d 依 37.5 d 依 33.6 d 依 26.8 d 依 25.7 d 依 28.4 d S 依依依依依依依 29.1 d P< BG x 依 s n=10 mmol L -1 G 依依依 2.72 df 依 2.72 df 依 3.36 df 依 3.45 df 依 1.29 dfh R 依依依 2.72 df 依 3.01 df 依 4.08 df 依 3.06 df 9.70 依 0.81 df B 依依依依 2.82 ce 依 2.77 df 依 3.49 df 依 2.39 dfg S 依依依依依依依 3.29 h c P<0.05 d P<0.01 S e P<0.05 f P<0.01 R g P<0.05 h P<0.01 元 ISI =In[1/ FBG 伊 INS ] 766

4 2013 绎 Vol.15 No.4 P<0.05 P< ISI P<0.05 P<0.01 GB ISI P<0.05 P< GB RYGBP BPD GB RYGBP BPD GB RYGBP BPD T2DM [6~9] STZ T2DM GB RYGBP BPD 3 T2DM 3 BG TC TG GB RYGBP BPD GBP [10, 11] GB 20% RYGBP BPD 4 TC TG x 依 s n=10 mmol L -1 G TC 4.31 依依 1.25 g 3.45 依 0.64 d 3.24 依 0.60 ed 3.07 依 0.58 df 2.80 依 0.48 df 2.32 依 0.45 df TG 2.42 依依依依 0.26 cf 1.90 依 0.26 df 1.53 依 0.41 df 1.38 依 0.32 df R TC 4.10 依依依 0.93 e 3.04 依 1.25 ce 2.71 依 0.90 df 2.14 依 0.95 df 2.22 依 0.79 df TG 2.46 依依依依 0.86 f 1.77 依 0.73 cf 1.39 依 0.47 df 1.16 依 0.41 df B TC 4.52 依依依 1.09 c 3.32 依 0.77 ce 2.77 依 0.88 df 2.25 依 0.92 df 2.13 依 0.31 df TG 2.61 依依依依 0.59 f 1.92 依 0.58 ce 1.32 依 0.60 df 1.23 依 0.35 df S TC 4.28 依依依依依依依 0.84 TG 2.31 依依依依依依依 0.53 c P<0.05 d P<0.01 S e P<0.05 f P<0.01 R g P< INS x 依 s n=10 mu L -1 G INS 依依依依依依依 ISI 依依依依依依 0.44 d 依 0.29 dfg R INS 依依依依依依依 c ISI 依依依依依依 0.39 c 依 0.24 dei B INS 依依依依依依依 ISI 依依依 0.22 c 依 0.28 d 依依 0.12 d 依 0.23 dei S INS 依依依依依依依 ISI 依依依依依依依 0.27 j c P<0.05 d P<0.01 S e P<0.05 f P<0.01 R g P<0.05 G i P<0.05 j P<

5 绎 [12] Insulin Resis 原 tance, IR 茁 T2DM IR IR ISI IR RYGBP 16 INS 3 INS GB RYGBP BPD ISI IR GB RYGBP BPD RYGBP 9.70 依 0.81 mmol L -1 IR BPD BPD 2 ISI GB RYGBP 8 ISI GB T2DM 1 Mokdad A H, Ford E S, Bowman B A, et al. Prevalence of obesity, diabetes, and obesity -related health risk factors, JAMA, 2003, 289(1) 颐 76~79. 2 Eid I, Birch D W, Sharma A M, et al. Complications associated with adjustable gastric banding for morbid obesity: a surgeon s guide. Can J Surg, 2011, 54(1) 颐 61~66. 3 Singhal R, Bryant C, Kitchen M, et al. Band slippage and erosion after laparoscopic gastric banding: a meta -analysis. Surg Endosc, 2010, 24(12) 颐 2980~ ,,. 2.,2012,33(8) 颐 8~11. 5,,Li11ioja S, 援.,1993,32(10) 颐 ,,,. 2.,2011,10(3) 颐 210~ Eriksson S, Backman L, Ljungsortm K G. The incidence of clinical postoperative thrombosis after gastric surgery for obesity during 16 years. Obes Surg, 1997, 7(4) 颐 332~ Scopinaro N, Admai G F, Marinari G M, et al. Biliopnacreatic di 原 version. World J Surg, 1998, 22(9) 颐 936~ Pories W J, MacDonald K G Jr, Morgan E J, et al. Surgical treat 原 ment of obesity and its effect on diabetes:10 -y follow -up. Am J Clin Nutr, 1992, 55(2Suppl) 颐 582S~585S. 10 Rubino F, Marescaux J. Effect of duodenal -jejunal exclusion in a non -obese animal model of type 2 diabetes: a new perspective for an old disease. Ann Surg, 2004, 239(1) 颐 1~11. 11,..,2006,26(3) 颐 176~ Rubino F, Forgione A, Cummings D E. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg, 2006, 244(5) 颐 741~749. Efficacy Comparison among Three Kinds of Surgical Operation for Type 2 Diabetes Mellitus in Rats Chen Jia, Wang Xiao, Zhang Yongbin, Gao Xin, Sang Chuanlan, Chen Yuan, Dong Haoran, Cao Chongbo (Laboratory A nimal Center, Guangzhou University of Chinese Medicine, Guangzhou , China) Abstract: This study was aimed to compare the efficacy of gastric banding (GB), Roux en -Y gastric bypass (RYGBP) and biliopancreatic diversion (BPD) in the treatment of rats with type 2 diabetes mellitus (T2DM). Ani 鄄 mal models of T2DM were induced by streptozotocin (STZ) injection and high -sugar -fat diets. A total of 70 T2DM rats were randomly allocated into the GB group (G group, n = 20), RYGBP group (R group, n = 20), BPD group (B group, n = 20), and the sham operation group (S group, n = 10). The fasting blood glucose (BG), triglyceride (TG), total cholesterol (TC) and insulin (INS) content were determined before and 1, 2, 3, 4, 8, 16 weeks after operation. The insulin sensitivity index (ISI) was calculated. The mortality and complications were ob 鄄 served in each group. The results showed that the fasting weight of the GB group, RYGBP group and BPD group were (324.4 依 22.5) g, (338.9 依 17.5) g, (333.3 依 28.4) g, respectively. The BG content was (12.44 依 1.29) mmol/l, (9.70 依 0.81) mmol/l, (11.93 依 2.39) mmol/l, respectively. The TC content was (2.32 依 0.45) mmol/ 768

6 2013 绎 Vol.15 No.4 L, (2.22 依 0.79) mmol/l, (2.13 依 0.31) mmol/l, respectively. The TG content was (1.38 依 0.32) mmol/l, (1.16 依 0.41) mmol/l, (1.23 依 0.35) mmol/l, respectively. The ISI were (-6.38 依 0.29), (-6.67 依 0.24), (-6.65 依 0.23), respectively. And the INS content of the RYGBP group were (69.43 依 18.73) mu/l. There were signifi 鄄 cant differences between before and after operation on the 16th week (P <0.05,P < 0.01). The mortality rate was 5% in the GB group, 20% in the RYGBP group, and 35% in the BPD group. It was concluded that the GB, RYGBP and BPD are effective in reducing blood glucose and blood lipids in the treatmentofratwitht2dm.the treatment effect is obvious in the improvement of insulin resistance (IR). Keywords: Gastric banding, gastric bypass, biliopancreatic diversion, type 2 diabetes mellitus, animal model 769

< F63756D656E D2D796E2D31C6DABFAF2D31D6D0D2BDD2A9CFD6B4FABBAF2D C4EA2DB5DA36C6DA2DB7E2C3E6CDC6BDE9A3A D36A3A92E6D6469>

< F63756D656E D2D796E2D31C6DABFAF2D31D6D0D2BDD2A9CFD6B4FABBAF2D C4EA2DB5DA36C6DA2DB7E2C3E6CDC6BDE9A3A D36A3A92E6D6469> 1. 530023 2. 530001 3. 530001 DCP 100 DCP 47 53 3 HOMA -IR HOMA - IR P