上海交通大学学报（医学版）

›› 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

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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