›› 2012, Vol. 32 ›› Issue (8): 1029-.doi: 10.3969/j.issn.1674-8115.2012.08.015

• 论著(基础研究) • 上一篇    下一篇

食管空肠覆膜支架转流术治疗2型糖尿病的实验研究

付唆林1, 朱惠明2, 郑 丽3, 王文军3   

  1. 1.暨南大学临床医学博士后流动站, 广州 510632; 2.暨南大学第二附属医院消化科, 深圳 518020; 3.南昌大学第三附属医院消化科, 南昌 330008
  • 出版日期:2012-08-28 发布日期:2012-08-29
  • 作者简介:付唆林(1969—), 男, 博士后;电子信箱: fusuolin@163.com。
  • 基金资助:

    江西省科技支撑计划项目(2010BSB01600)

Experimental study of esophagus-jejunum stent bypass in treatment of type 2 diabetes mellitus

FU Suo-lin1, ZHU Hui-ming2, ZHENG Li3, WANG Wen-jun3   

  1. 1.Clinical Medical Postdoctoral Research Station, Jinan University, Guangzhou 510632, China;2.Department of Gastroenterology, the Second Affiliated Hospital of Jinan University, Shenzhen 518020, China;3.Department of Gastroenterology, the Third Affiliated Hospital of Nanchang University, Nanchang 330008, China
  • Online:2012-08-28 Published:2012-08-29
  • Supported by:

    Jiangxi Science and Technology Support Program, 2010BSB01600

摘要:

目的 观察内镜下(联合开腹手术)食管空肠覆膜支架转流术对肥胖症并2型糖尿病(T2DM)模型犬的治疗效果。方法 对肥胖症并T2DM模型犬(实验组,n=5)实施内镜下(联合开腹手术)食管空肠覆膜支架转流术,分别于术前和术后4、8、12周时测定空腹血糖和胰岛素,行静脉葡萄糖耐量试验(IVGTT),采用稳态模型评估β细胞功能(HOMA-β)和胰岛素抵抗(HOMA-IR)。以仅行胃镜检查和剖腹探查术的正常Beagle犬作为对照组(n=5)。结果实验组术后4周时的空腹血糖、IVGTT-2 h血糖、空腹胰岛素和IVGTT-2 h胰岛素即已显著低于术前水平(P<0.01),术后12周时,实验组空腹血糖浓度与对照组比较,差异无统计学意义(P>0.05)。与术前比较,术后实验组HOMA-IR逐渐下降(P<0.01),HOMA-β则缓慢上升(P<0.01,P<0.05),至术后12周时,实验组HOMA-IR和HOMA-β与对照组比较,差异均无统计学意义(P>0.05)。结论 对肥胖症并T2DM模型犬实施内镜下(联合开腹手术)食管空肠覆膜支架转流术,可模拟并改良经典的Roux-en-Y胃转流术,治疗T2DM安全有效。

关键词: 2型糖尿病, 内镜, 支架, 胃转流术, 动物模型

Abstract:

Objective To observe the effect of endoscopic esophagus-jejunum stent bypass (combined with laparotomy) on type 2 diabetes mellitus (T2DM) complicated with obesity in model dogs. Methods Five model dogs with T2DM complicated with obesity (experiment group) underwent endoscopic esophagus-jejunum stent bypass (combined with laparotomy). Before treatment and 4 weeks, 8 weeks and 12 weeks after treatment, fasting plasma glucose and fasting insulin were measured, intravenous glucose tolerance test (IVGTT) was performed, and β cell function and insulin resistance were evaluated with homeostasis model assessment (HOMA-β and HOMA-IR). Besides, another 5 normal Beagle dogs undergoing endoscopy and exploratory laparotomy were served as control group. Results Four weeks after treatment, the fasting plasma glucose, IVGTT-2 h plasma glucose, fasting insulin and IVGTT-2 h insulin were significantly lower than those before treatment in experiment group (P<0.01). There was no significant difference in fasting plasma glucose between experiment group and control group 12 weeks after treatment (P>0.05). HOMAIR gradually decreased (P<0.01) and HOMA-β gradually increased (P<0.01, P<0.05) in experiment group after treatment. There was no significant difference in HOMA-IR and HOMA-β between experiment group and control group 12 weeks after treatment (P>0.05). Conclusion Endoscopic esophagus-jejunum stent bypass (combined with laparotomy) can simulate and improve classic Roux-en-Y gastric bypass in model dogs with T2DM complicated with obesity, and can treat T2DM effectively and safely.

Key words: type 2 diabetes mellitus, endoscopy, stent, gastric bypass, animal model