Roux-en-Y胃旁路术与外源性胰岛素治疗2型糖尿病大鼠疗效分析

目的：对链脲佐菌素引起的2型糖尿病大鼠采用胃旁路术（GBP）与外源性胰岛素治疗，观察和比较两者的近期疗效以及治疗后大鼠的胰岛细胞数目变化情况。方法：选择体格健壮的67只大鼠，采用腹腔注射链脲佐菌素的方式建立2型糖尿病研究模型，随机分为对照组（n=20）、胰岛素组（n=20）、GBP组（n=27），术前和术后1、4、12周动态监测3组大鼠的体重、空腹血糖以及空腹C肽，术后12周处死大鼠，进行胰岛素免疫组化分析，并观察大鼠的胰岛数目以及胰岛的分泌情况。结果：术后4、12周，GBP组体重与对照组、胰岛素组比较差异有统计学意义（P〈0．05）。术后GBP组、胰岛素组空腹血糖明显下降（P〈0．05）。术后4、12周，GBP组、胰岛素空腹C肽明显高于对照组（P〈0．05）；术后12周，GBP组空腹C肽明显高于胰岛素组（P〈0．05），平均胰岛数量明显高于对照组和胰岛素组（P〈0．05），胰岛素免疫组化平均灰度值明显低于对照组和胰岛素组（P〈0．05）。结论：采用短期内胃旁路术治疗2型糖尿病大鼠的胰岛细胞出现增生，大鼠的胰岛素分泌液得到改善，疗效优于外源性胰岛素的治疗效果，其长期疗效需进一步分析。

Effect of Roux-en-Y gastric bypass surgery and exogenous insulin administration on type 2 diabetic rats

Objective： To compare effect of gastric bypass surgery （GBP） and exogenous insulin treatment on type 2 diabetic rats. Methods： Type 2 diabetic model of 67 rats was established by intraper- itoneal injection of chain urea via cephalosporins way. Then they were randomly divided into control group, insulin group and GBP group. Weight, fasting plasma glucose and fasting c-peptide were measured before operation, 1 week, 4 weeks, 12 weeks after surgery. They were killed 12 weeks after surgery. In- sulin immunohistochemical analysis was performed. Islet number and islet secretion were also observed.Results： There was significant difference in weight between GBP group and control group ＆ insulin group 4, 12 week after surgery （P〈0.05）. In GBP and insulin group postoperative fasting glucose were signifi- cantly decreased （P〈0.05）. 4, 12 weeks after surgery, fasting C peptide in GBP and insulin groups was significantly higher than that of control group （P〈0.05）. And 12 weeks after surgery, fasting c-peptide of GBP group was significantly higher than that of insulin group （t= 5. 407, P〈0.05）. After 12 weeks, the average islet number of GBP group was significantly higher than that of control group and insulin group （P〈0.05） ; 12 weeks after surgery, average grey value of GBP group was significantly lower than that of control group and insulin group （P〈0.05）. Conclusions：Type 2 diabetic rats with gastric bypass surgery treatment have islet cell hyperplasia in the short term, and insulin secretion was improved. The effect is more significant than that of exogenous insulin. However, the long-term curative effect still need further research.