改良胃袖狀切除對肥胖大鼠ghrelin及胰高血糖素樣肽-1水平的影響_《中國普外基礎與臨床雜志》

作者：

嚴玲玲 , 朱占永 , 吳丹 , 吳毅平

華中科技大學同濟醫學院附屬同濟醫院整形外科(湖北武漢 430030);

關鍵詞：

改良胃袖狀切除術飲食誘導肥胖大鼠生長激素釋放肽ghrelin 胰高血糖素樣肽-1

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目的根據胃腸道不同部位激素分泌的特點，探討一種新的長期減重效果明顯的手術方式。方法高脂飲食誘導Wistar肥胖大鼠35只，然后將誘導成功的肥胖大鼠按完全隨機方法分為改良胃袖狀切除術組(n=12)、胃袖狀切除術組(n=12)及假手術組(n=11)3組，分別比較3組大鼠術前、術后連續8周的體重和攝食量，以及術前及術后第8周時外周血清中生長激素釋放肽ghrelin和胰高血糖素樣肽-1(GLP-1)水平的變化。結果①大鼠體重和攝食量： 3組間術前大鼠的體重和攝食量差異均無統計學意義(P gt;0.05)。改良胃袖狀切除術組和胃袖狀切除術組術后1~8周，大鼠的體重均較假手術組明顯下降(P lt;0.05)，改良胃袖狀切除術組較胃袖狀切除術組大鼠的體重也明顯下降(P lt;0.05)。改良胃袖狀切除術組術后1~8周大鼠的攝食量較假手術組明顯減少(P lt;0.05)，改良胃袖狀切除術組于術后3、6、7及8周大鼠的攝食量較胃袖狀切除術組大鼠明顯減少(P lt;0.05)。②外周血清中ghrelin和GLP-1水平： 3組間術前大鼠ghrelin和GLP-1水平變化差異均無統計學意義(P gt;0.05); 術后第8周，血清ghrelin水平改良胃袖狀切除術組和胃袖狀切除術組均較假手術組明顯下降(P lt;0.05)，改良胃袖狀切除術組又較胃袖狀切除術組明顯下降(P lt;0.05); GLP-1水平改良胃袖狀切除術組較假手術組和胃袖狀切除術組明顯升高(P lt;0.05)。同時，術后第8周時改良胃袖狀切除術組和胃袖狀切除術組ghrelin水平較術前明顯下降(P lt;0.05)，GLP-1水平在改良胃袖狀切除術組較術前明顯升高(P lt;0.05)。結論改良胃袖狀切除術在肥胖大鼠模型中成功實施為進一步探索其臨床應用提供了可能。

引用本文： 嚴玲玲,朱占永,吳丹,吳毅平. 改良胃袖狀切除對肥胖大鼠ghrelin及胰高血糖素樣肽-1水平的影響. 中國普外基礎與臨床雜志, 2011, 18(5): 498-502. doi: 復制

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2.	Samer G, Mattar MD. Lifting the unbearable weight of morbid obesity [J]. Ann Surg, 2008, 247(1): 2829.
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4.	Safer DJ. Diet, behavior modification, and exercise: a review of obesity treatments from a longterm perspective [J]. South Med J, 1991, 84(12): 14701474.
5.	Clark A, Franklin J, Pratt I, et al. Overweight and obesity-use of portion control in management [J]. Aust Fam Physician, 2010, 39(6): 407411.
6.	Hearnshaw C, Matyka K. Managing childhood obesity: when lifestyle change is not enough [J]. Diabetes Obes Metab, 2010, 12(11): 947957.
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8.	Hüttl TP, Jauch KW. Surgical therapy of morbid obesity [J]. MMW Fortschr Med, 2010, 152(22): 3235.
9.	Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weightloss procedure for highrisk patients with morbid obesity [J]. Surg Endosc, 2006, 20(6): 859863.
10.	Kodama Y, Zhao CM, Kulseng B, et al. Eating behavior in rats subjected to vagotomy, sleeve gastrectomy, and duodenal switch [J]. J Gastrointest Surg, 2010, 14(10): 15021510.
11.	Rice RD, Simon TE, Seery JM, et al. Laparoscopic sleeve gastrectomy: outcomes at a military training center [J]. Am Surg, 2010, 76(8): 835840.
12.	Himpens J, Dobbeleir J, Peeters G. Longterm results of laparoscopic sleeve gastrectomy for obesity [J]. Ann Surg, 2010, 252(2): 319324.
13.	Langer FB, Bohdjalian A, ShakeriLeidenmühler S, et al. Conversion from sleeve gastrectomy to RouxenY gastric bypassindications and outcome [J]. Obes Surg, 2010, 20(7): 835840.
14.	Suzuki K, Simpson KA, Minnion JS. The role of gut hormones and the hypothalamus in appetite regulation [J]. Endocr J, 2010, 57(5): 359372.
15.	Maljaars J, Romeyn EA, Haddeman E, et al. Effect of fat saturation on satiety, hormone release, and food intake [J]. Am J Clin Nutr, 2009, 89(4): 10191024.
16.	鄧治洲, 王烈, 林憶陽, 等. 胃轉流術對非肥胖型2型糖尿病的療效觀察及其對胰高血糖素樣肽1的影響 [J]. 中國普外基礎與臨床雜志, 2009, 16(6): 466469.
17.	Shin AC, Zheng H, Townsend RL, et al. Mealinduced hormone responses in a rat model of RouxenY gastric bypass surgery [J]. Endocrinology, 2010, 151(4): 15881597.
18.	Laferrère B. Effect of gastric bypass surgery on the incretins [J]. Diabetes Metab, 2009, 35(6 Pt 2): 513517.
19.	Bueter M, Ashrafian H, le Roux CW. Mechanisms of weight loss after gastric bypass and gastric banding [J]. Obes Facts, 2009, 2(5): 325331.
20.	Ursavas A, Ilcol YO, Nalci N, et al. Ghrelin, leptin, adiponectin, and resistin levels in sleep apnea syndrome: Role of obesity [J]. Ann Thorac Med, 2010, 5(3): 161165.
21.	Aguirre V, Stylopoulos N, Grinbaum R, et al. An endoluminal sleeve induces substantial weight loss and normalizes glucose homeostasis in rats with dietinduced obesity [J]. Obesity, 2008, 16(12): 25852592.
22.	AbuJaish W, Rosenthal RJ. Sleeve gastrectomy: a new surgical approach for morbid obesity [J]. Expert Rev Gastroenterol Hepatol, 2010, 4(1): 101119.
23.	Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure [J]. Surg Obes Relat Dis, 2009, 5(4): 469475.
24.	Nowak A, Bojanowska E. Effects of peripheral or central GLP1 receptor blockade on leptininduced suppression of appetite [J]. J Physiol Pharmacol, 2008, 59(3): 501510.
25.	Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy for morbid obesity [J]. World J Gastroenterol, 2008, 14(6): 821827.

1. Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after dietinduced weight loss or gastric bypass surgery [J]. N Engl J Med, 2002, 346(21): 16231630.
2. Samer G, Mattar MD. Lifting the unbearable weight of morbid obesity [J]. Ann Surg, 2008, 247(1): 2829.
3. 張洪義. 外科手術治療病態性肥胖癥的現代進展 [J]. 空軍總醫院學報, 2006, 22(3): 165167.
4. Safer DJ. Diet, behavior modification, and exercise: a review of obesity treatments from a longterm perspective [J]. South Med J, 1991, 84(12): 14701474.
5. Clark A, Franklin J, Pratt I, et al. Overweight and obesity-use of portion control in management [J]. Aust Fam Physician, 2010, 39(6): 407411.
6. Hearnshaw C, Matyka K. Managing childhood obesity: when lifestyle change is not enough [J]. Diabetes Obes Metab, 2010, 12(11): 947957.
7. Chang CY, Huang CK, Chang YY, et al. Prospective study of healthrelated quality of life after RouxenY bypass surgery for morbid obesity [J]. Br J Surg, 2010, 97(10): 15411546.
8. Hüttl TP, Jauch KW. Surgical therapy of morbid obesity [J]. MMW Fortschr Med, 2010, 152(22): 3235.
9. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weightloss procedure for highrisk patients with morbid obesity [J]. Surg Endosc, 2006, 20(6): 859863.
10. Kodama Y, Zhao CM, Kulseng B, et al. Eating behavior in rats subjected to vagotomy, sleeve gastrectomy, and duodenal switch [J]. J Gastrointest Surg, 2010, 14(10): 15021510.
11. Rice RD, Simon TE, Seery JM, et al. Laparoscopic sleeve gastrectomy: outcomes at a military training center [J]. Am Surg, 2010, 76(8): 835840.
12. Himpens J, Dobbeleir J, Peeters G. Longterm results of laparoscopic sleeve gastrectomy for obesity [J]. Ann Surg, 2010, 252(2): 319324.
13. Langer FB, Bohdjalian A, ShakeriLeidenmühler S, et al. Conversion from sleeve gastrectomy to RouxenY gastric bypassindications and outcome [J]. Obes Surg, 2010, 20(7): 835840.
14. Suzuki K, Simpson KA, Minnion JS. The role of gut hormones and the hypothalamus in appetite regulation [J]. Endocr J, 2010, 57(5): 359372.
15. Maljaars J, Romeyn EA, Haddeman E, et al. Effect of fat saturation on satiety, hormone release, and food intake [J]. Am J Clin Nutr, 2009, 89(4): 10191024.
16. 鄧治洲, 王烈, 林憶陽, 等. 胃轉流術對非肥胖型2型糖尿病的療效觀察及其對胰高血糖素樣肽1的影響 [J]. 中國普外基礎與臨床雜志, 2009, 16(6): 466469.
17. Shin AC, Zheng H, Townsend RL, et al. Mealinduced hormone responses in a rat model of RouxenY gastric bypass surgery [J]. Endocrinology, 2010, 151(4): 15881597.
18. Laferrère B. Effect of gastric bypass surgery on the incretins [J]. Diabetes Metab, 2009, 35(6 Pt 2): 513517.
19. Bueter M, Ashrafian H, le Roux CW. Mechanisms of weight loss after gastric bypass and gastric banding [J]. Obes Facts, 2009, 2(5): 325331.
20. Ursavas A, Ilcol YO, Nalci N, et al. Ghrelin, leptin, adiponectin, and resistin levels in sleep apnea syndrome: Role of obesity [J]. Ann Thorac Med, 2010, 5(3): 161165.
21. Aguirre V, Stylopoulos N, Grinbaum R, et al. An endoluminal sleeve induces substantial weight loss and normalizes glucose homeostasis in rats with dietinduced obesity [J]. Obesity, 2008, 16(12): 25852592.
22. AbuJaish W, Rosenthal RJ. Sleeve gastrectomy: a new surgical approach for morbid obesity [J]. Expert Rev Gastroenterol Hepatol, 2010, 4(1): 101119.
23. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure [J]. Surg Obes Relat Dis, 2009, 5(4): 469475.
24. Nowak A, Bojanowska E. Effects of peripheral or central GLP1 receptor blockade on leptininduced suppression of appetite [J]. J Physiol Pharmacol, 2008, 59(3): 501510.
25. Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy for morbid obesity [J]. World J Gastroenterol, 2008, 14(6): 821827.

《中國普外基礎與臨床雜志》

改良胃袖狀切除對肥胖大鼠ghrelin及胰高血糖素樣肽-1水平的影響

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《中國普外基礎與臨床雜志》

改良胃袖狀切除對肥胖大鼠ghrelin及胰高血糖素樣肽-1水平的影響

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

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