摘要目的 观察十二指肠腔内套管置入术(endoluminal sleeve,ELS)对非肥胖型2型糖尿病(type 2 dabetes mellitus,T2DM)大鼠糖代谢的影响.方法 24只雄性自发性糖尿病Goto-Kakizaki (GK)大鼠按随机数字表法分为手术(ELS)组和假手术(sham-operation,SO)组,每组12只.观察术前(0周),术后1、3、6、12、24周2组空腹血糖(fasting plasma glucose,FPG)水平,术前(0周),术后6、24周行口服葡萄糖耐量试验(oral glucose tolerance test,OGTT),描绘血糖随时间变化曲线,计算葡萄糖耐量曲线下面积(areaunder the curve,AUC),并测定葡萄糖负荷2h后胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)水平.结果 术前2组大鼠间各项指标差异无统计学意义;与术前比较,ELS组术后1、3、6、12、24周FPG显著降低,差异有统计学意义(F组内=5.982,P=0.023),术后6、24周AUC、血糖峰值低于术前,差异有统计学意义(F组内=11.602,P=0.003),且OGTT血糖峰值出现时间由原来的60 min提前到30 min,葡萄糖负荷后的GLP-1水平明显升高,差异有统计学意义(F组内=43.24,P=0.012);SO组术后各指标差异无统计学意义.结论 十二指肠腔内套管置入术对菲肥胖型T2DM大鼠具有稳定控制血糖和改善糖耐量的作用.

abstractsObjective To observe the effect of duodenal endoluminal sleeve (ELS)on.glucose metabolism of non-obese type 2 diabetes mellitus (T2DM)rats.Methods 24 male spontaneously diabetic Goto-Kakizaki (GK) rats were randomly divided into surgery group(ELS,n =12)and sham-operated group (SO,n =12).Fasting plasma glucose(FPG) levels of the 2 groups were observed before surgery(0 weeks),or on 1 st,3rd 6th,12th,and 24th week after surgery.Oral glucose tolerance test(OGTT) was performed before surgery (0 weeks),or on 6th and 24th week after surgery.Blood glucose versus time curve was depicted and glucose tolerance area under the curve(AUC)was calculated.Glucagon-like peptide-1 (GLP-1)concentration levels were measured 2 hours after glucose load.Results There was no significant difference between the 2 groups in various indicators before surgery.For ELS group,FPG level significantly decreased on 1 st,3rd 6th,12th,and 24th week after surgery (Fintra-group =5.982,P ＜ 0.01)compared with that before surgery.AUC and blood glucose peak were both loweron 6th and 24th week after surgery than those before surgery (Fintya-group =11.602,P =0.003).OGTT glucose peak reduced to 30 minutes from the original 60 minutes.GLP-1 level significantly increased after glucose load (Fintra-group =43.24,P ＜ 0.05) ; All the index of SO group had no significant change.Conclusion Duodenal ELS has effect on blood glucose control and glucose tolerance improvement in non-obese T2DM rats.