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目的观察胃旁路术(GBP)对链脲佐菌素(STZ)诱发的糖尿病大鼠降糖作用。探讨其机制。方法SD大鼠注射STZ建立糖尿病模型后分为手术组(O组)、假手术组(S组)、饮食控制组(F组)、对照组(C组),每组8只,测术前,术后第1、2、3、4、8周空腹和口服葡萄糖后血糖、胰岛素、胰高血糖素样肽-1(GLP-1)和体重、平均进食量。结果O组GBP后3周,空腹和餐后血糖分别由(16.84±3.82)、(31.88±6.22)mmol/L下降到(13.24±3.53)、(17.35±3.47)mmol/L(P值均＜0.05),空腹和餐后胰岛素分别由(28.66±8.17)、(30.73±8.99)mIU/L上升到(46.48±10.41)、(51.14±11.45)mIU/L(P值均＜0.01)。空腹和餐后GLP-1分别由(7.02±2.10)、(42.20±11.16)pmol/L上升到(25.16±7.30)、(97.83±30.23)pmol/L(P值均＜0.01)。GLP-1和血糖成负相关(P＜0.01),GLP-1和胰岛素成正相关(P＜0.01)。S组体重改变与O组相似,血糖无明显下降；F组控制平均进食量约为O组的1/3并致显著体重下降,血糖下降没有O组明显(P＜0.05)。结论GBP能显著降低STZ大鼠血糖,可能通过术后GLP-1分泌增多起作用。GBP的降糖作用与术后大鼠饮食减少和体重下降无关。
Objective To observe the hypoglycemic effect of gastric bypass (GBP) on streptozotocin (STZ) -induced diabetic rats. Explore its mechanism. Methods SD rats were injected with STZ to establish diabetic model and then divided into operation group (O group), sham operation group (S group), diet control group (F group) and control group (C group) The fasting and oral glucose levels, insulin, glucagon-like peptide-1 (GLP-1), body weight and average food intake were measured at 1, 2, 3, 4 and 8 weeks after operation. Results The fasting and postprandial blood glucose decreased from (16.84 ± 3.82) and (31.88 ± 6.22) mmol / L to (13.24 ± 3.53) and (17.35 ± 3.47) mmol / L, 0.05). Fasting and postprandial insulin increased from (28.66 ± 8.17) and (30.73 ± 8.99) mIU / L to (46.48 ± 10.41) and (51.14 ± 11.45) mIU / L respectively (all P <0.01). Fasting and postprandial GLP-1 increased from (7.02 ± 2.10) and (42.20 ± 11.16) pmol / L to (25.16 ± 7.30) and (97.83 ± 30.23) pmol / L, respectively. There was a negative correlation between GLP-1 and blood glucose (P <0.01), and a positive correlation between GLP-1 and insulin (P <0.01). The body weight of group S was similar to that of group O, and the blood sugar did not decrease obviously. The average food intake of group F was about 1/3 of that of group O, and the body weight of group O was significantly decreased. There was no obvious decrease of blood glucose in group O (P <0.05). Conclusion GBP can significantly reduce blood glucose in STZ rats and may play an important role in the postoperative GLP-1 secretion. The hypoglycemic effect of GBP has nothing to do with postoperative diet reduction and weight loss in rats.