摘要目的 通过对糖耐量正常犬行胃旁路手术,观察术后糖耐量、糖依赖性胰岛素释放肽(gastric inhibitory polypeptide,GIP)和胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)的变化,探讨胃旁路手术治疗2型糖尿病的机制.方法 选取6只糖耐量正常犬行胃旁路手术,于术前、术后1、2、4周行口服与静脉糖耐量实验,观察各时点血糖、胰岛素、GIP、GLP-1变化,以及术前、术后4周胰腺组织形态改变.结果 与术前比较,术后第2周空腹血糖[(3.58 ±O.33) mmol/L]明显降低(t=3.571,P＜0.05)；术后第1周空腹及口服葡萄糖后30 min时GLP-1升高[分别为(0.90±0.21)、(0.91±0.19) pmol/L,t=-3.660、-2.971,P＜0.05],第2周时开始下降；术后第4周各指标基本恢复至术前水平.术后第4周时与术前比较,胰岛组织形态、胰岛数量(分别为6.8±0.8、7.1±0.8)及胰岛细胞数量(分别为16.7±2.5、16.3±3.1)均无明显变化(P＞0.05).结论 胃旁路手术对糖耐量正常犬的血糖、胰岛素及部分糖尿病相关胃肠激素仅有短暂的影响.

abstractsObjective To observe postoperative glucose tolerance,gastric inhibitory polypeptide (GIP),and glucogan-like peptide-1 (GLP-1) in normal glucose level dogs after undergoing gastric bypass procedures,and to explore the mechanism of gastric bypass procedures to treat type 2 diabetes.Methods The 6 dogs with normal glucose tolerance had undergone gastric bypass procedures,and measure preoperative and postoperative oral and intravenous glucose tolerance (at time points 1,2,and 4 weeks) through changes in blood glucose,insulin,gastric inhibitory polypeptide (GIP),glucagon-like peptide-1 (GLP-1),and measure preoperative and postoperative week 4 pancreatic tissue morphology.Results Second weeks after operation,the fasting blood sugar was (3.58 ± 0.33) mmol/L,and significantly lower than preoperative (t =3.571,P ＜0.05).The GLP-1 level before oral glucose tolerance test (OGTT) and 30 minutes after OGTF were (0.90 ± 0.21) and (0.91 ± 0.19) pmol/L respectively,and significantly higher than preoperative (t value were-3.660 and-2.971,P ＜0.05).GLP-1 levels began to decrease in the second week after surgery.After 4 weeks,the index recovered to the preoperative level.Four weeks after surgery when compared with preoperative,islet morphology,islet number (6.8 ± 0.8 and 7.1 ± 0.8 respectively)and islet cells (16.7 ± 2.5 and 16.3 ± 3.1 respectively) did not change significantly (P＞0.05).Conclusion Gastric bypass procedures could be briefly affect normal glucose tolerance in dogs'blood glucose,insulin and diabetes-related gastrointestinal hormones.