• 福建醫(yī)科大學(xué)福總臨床醫(yī)學(xué)院(南京軍區(qū)福州總醫(yī)院)普通外科(福建福州 350025);

目的  探討以Goto-Kakizaki (GK)大鼠建立保留全胃的十二指腸空腸曠置術(shù)(DJB)模型的可行性及操作要點(diǎn)。
方法  將16只GK大鼠隨機(jī)分為實(shí)驗(yàn)組(n=8)和對(duì)照組(n=8)。在規(guī)范的術(shù)前、術(shù)中及術(shù)后操作下,對(duì)實(shí)驗(yàn)組和對(duì)照組大鼠分別行DJB術(shù)和假手術(shù),比較2組大鼠術(shù)前,術(shù)后1、2、3及4周空腹血糖和體質(zhì)量的變化情況,評(píng)價(jià)手術(shù)造模是否成功,并觀察2組大鼠的存活情況。
結(jié)果  術(shù)后4周2組大鼠均全部存活。與術(shù)前比較,實(shí)驗(yàn)組術(shù)后1周空腹血糖即下降(P<0.05),術(shù)后2、3及4周血糖趨于穩(wěn)定;對(duì)照組術(shù)后各時(shí)相空腹血糖水平無(wú)明顯變化(P>0.05)。術(shù)后各時(shí)相實(shí)驗(yàn)組的空腹血糖水平均低于對(duì)照組(P<0.05),提示成功建立了模型。實(shí)驗(yàn)組術(shù)后4周體質(zhì)量的增加值低于對(duì)照組(P<0.05)。
結(jié)論  DJB是一種可行的、安全有效的降糖術(shù)式。規(guī)范實(shí)驗(yàn)操作程序可以降低術(shù)中風(fēng)險(xiǎn),建立穩(wěn)定的GK大鼠DJB模型。

引用本文: 劉彬,喻敏,張?jiān)僦?陳鑫,王俊杰,黃盛,王烈,王瑜,王冰. Goto-Kakizaki大鼠十二指腸空腸曠置術(shù)模型的建立△. 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(9): 1013-1017. doi: 復(fù)制

1. Cummings DE, Flum DR. Gastrointestinal surgery as a treatment for diabetes[J]. JAMA, 2008, 299(3):341-343.
2. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity[J]. Ann Surg, 2000, 232(4):515-529.
3. Cummings DE, Overduin H, Foster-Schubert KE. Gastric bypass for obesity:mechanisms of weight loss and diabetes resolution[J].J Clin Endocrinol Metab, 2004, 89(6):2608-2615.
4. Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus[J]. Ann Surg, 2003, 238(4):467-484.
5. Pories WJ. Diabetes:the evolution of a new paradigm[J]. Ann Surg, 2004, 239(1):12-13.
6. Hickey MS, Pories WJ, MacDonald KG, et al. A new paradigm for type 2 diabetes mellitus:could it be a disease of the foregut?[J]. Ann Surg, 1998, 227(5):637-643.
7. Rubino F, Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes:a new perspective for an old disease[J]. Ann Surg, 2004, 239(1):1-11.
8. 王瑜, 王燕婷, 王烈. 胃轉(zhuǎn)流術(shù)對(duì)非肥胖型2型糖尿病的治療作用[J]. 中國(guó)普通外科雜志, 2008, 17(10):1003-1006.
9. Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes[J]. Ann Surg, 2006, 244(5):741-749.
10. Araujo AC, Bonfleur ML, Balbo SL, et al. Duodenal-jejunal bypass surgery enhances glucose tolerance and beta-cell function in western diet obese rats[J]. Obes Surg, 2012, 22(5):819-826.
11. Klein S, Fabbrini E, Patterson BW, et al. Moderate effect of duod-enal-jejunal bypass surgery on glucose homeostasis in patients with type 2 diabetes[J]. Obesity (Silver Spring), 2012, 20(6):1266-1272.
12. Geloneze B, Geloneze SR, Chaim E, et al. Metabolic surgery fornon-obese type 2 diabetes:incretins, adipocytokines, and insulin secretion/resistance changes in a 1-year interventional clinical cont-rolled study[J]. Ann Surg, 2012, 256(1):72-78.
13. Portha B, Giroix MH, Tourrel-Cuzin C, et al. The GK rat:a prototype for the study of non-overweight type 2 diabetes[J]. Methods Mol Biol, 2012, 933:125-159.
14. Kimura K, Toyota T, Kakizaki M, et al. Impaired insulin secretion in the spontaneous diabetes rats[J]. Tohoku J Exp Med, 1982, 137(4):453-539.
15. de Luis D, Domingo M, Romero A, et al. Effects of duodenal-jejunal exclusion on beta cell function and hormonal regulation in Goto-Kakizaki rats[J]. Am J Surg, 2012, 204(2):242-247.
16. Bradley D, Conte C, Mittendorfer B, et al. Gastric bypass and banding equally improve insulin sensitivity and β cell function[J].J Clin Invest, 2012, 122(12):4667-4674.
17. Liu Y, Zhou Y, Wang Y, et al. Roux-en-Y gastric bypass-inducedimprovement of glucose tolerance and insulin resistance in type 2 diabetic rats are mediated by glucagon-like peptide-1[J]. Obes Surg, 2011, 21(9):1424-1431.
18. Zhang X, Huang W, Zhang Y, et al. Effects of Roux-en-Y operations on glucose homeostasis in obese GK rats[J]. Surg Endosc, 2011, 25(11):3493-3498.
19. Mueller RA, Lundberg DB, Breese GR, et al. The neuropharmacology of respiratory control[J]. Neuropharmacol Rev, 1982, 34(3):255-285.
20. Vila J. Protection from pentobarbital lethality mediated by pavlovianconditioning[J]. Pharmacol Biochem Behav, 1989, 32(1):365-366.
21. Han LO, Zhou LH, Cheng SJ, et al. Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats[J]. World J Gastr-oenterol, 2011, 17(45):5021-5027.
22. Flegal MC, Kuhlman SM. Anesthesia monitoring equipment for laboratory animals[J]. Lab Anim (NY), 2004, 33(7):31-36.
23. Lopez-Vidriero MT, Costello J, Clark TJ, et al. Effect of atropineon sputum production[J]. Thorax, 1975, 30(5):543-547.
24. Burch JM, Denton JR, Noble RD. Physiologic rationale for abbre-viated laparotomy[J]. Surg Clin North Am, 1997, 77(4):779-782.
25. Sessler DI. Mild perioperative hypothermia[J]. N Engl J Med, 1997, 336(24):1730-1737.
  1. 1. Cummings DE, Flum DR. Gastrointestinal surgery as a treatment for diabetes[J]. JAMA, 2008, 299(3):341-343.
  2. 2. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity[J]. Ann Surg, 2000, 232(4):515-529.
  3. 3. Cummings DE, Overduin H, Foster-Schubert KE. Gastric bypass for obesity:mechanisms of weight loss and diabetes resolution[J].J Clin Endocrinol Metab, 2004, 89(6):2608-2615.
  4. 4. Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus[J]. Ann Surg, 2003, 238(4):467-484.
  5. 5. Pories WJ. Diabetes:the evolution of a new paradigm[J]. Ann Surg, 2004, 239(1):12-13.
  6. 6. Hickey MS, Pories WJ, MacDonald KG, et al. A new paradigm for type 2 diabetes mellitus:could it be a disease of the foregut?[J]. Ann Surg, 1998, 227(5):637-643.
  7. 7. Rubino F, Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes:a new perspective for an old disease[J]. Ann Surg, 2004, 239(1):1-11.
  8. 8. 王瑜, 王燕婷, 王烈. 胃轉(zhuǎn)流術(shù)對(duì)非肥胖型2型糖尿病的治療作用[J]. 中國(guó)普通外科雜志, 2008, 17(10):1003-1006.
  9. 9. Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes[J]. Ann Surg, 2006, 244(5):741-749.
  10. 10. Araujo AC, Bonfleur ML, Balbo SL, et al. Duodenal-jejunal bypass surgery enhances glucose tolerance and beta-cell function in western diet obese rats[J]. Obes Surg, 2012, 22(5):819-826.
  11. 11. Klein S, Fabbrini E, Patterson BW, et al. Moderate effect of duod-enal-jejunal bypass surgery on glucose homeostasis in patients with type 2 diabetes[J]. Obesity (Silver Spring), 2012, 20(6):1266-1272.
  12. 12. Geloneze B, Geloneze SR, Chaim E, et al. Metabolic surgery fornon-obese type 2 diabetes:incretins, adipocytokines, and insulin secretion/resistance changes in a 1-year interventional clinical cont-rolled study[J]. Ann Surg, 2012, 256(1):72-78.
  13. 13. Portha B, Giroix MH, Tourrel-Cuzin C, et al. The GK rat:a prototype for the study of non-overweight type 2 diabetes[J]. Methods Mol Biol, 2012, 933:125-159.
  14. 14. Kimura K, Toyota T, Kakizaki M, et al. Impaired insulin secretion in the spontaneous diabetes rats[J]. Tohoku J Exp Med, 1982, 137(4):453-539.
  15. 15. de Luis D, Domingo M, Romero A, et al. Effects of duodenal-jejunal exclusion on beta cell function and hormonal regulation in Goto-Kakizaki rats[J]. Am J Surg, 2012, 204(2):242-247.
  16. 16. Bradley D, Conte C, Mittendorfer B, et al. Gastric bypass and banding equally improve insulin sensitivity and β cell function[J].J Clin Invest, 2012, 122(12):4667-4674.
  17. 17. Liu Y, Zhou Y, Wang Y, et al. Roux-en-Y gastric bypass-inducedimprovement of glucose tolerance and insulin resistance in type 2 diabetic rats are mediated by glucagon-like peptide-1[J]. Obes Surg, 2011, 21(9):1424-1431.
  18. 18. Zhang X, Huang W, Zhang Y, et al. Effects of Roux-en-Y operations on glucose homeostasis in obese GK rats[J]. Surg Endosc, 2011, 25(11):3493-3498.
  19. 19. Mueller RA, Lundberg DB, Breese GR, et al. The neuropharmacology of respiratory control[J]. Neuropharmacol Rev, 1982, 34(3):255-285.
  20. 20. Vila J. Protection from pentobarbital lethality mediated by pavlovianconditioning[J]. Pharmacol Biochem Behav, 1989, 32(1):365-366.
  21. 21. Han LO, Zhou LH, Cheng SJ, et al. Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats[J]. World J Gastr-oenterol, 2011, 17(45):5021-5027.
  22. 22. Flegal MC, Kuhlman SM. Anesthesia monitoring equipment for laboratory animals[J]. Lab Anim (NY), 2004, 33(7):31-36.
  23. 23. Lopez-Vidriero MT, Costello J, Clark TJ, et al. Effect of atropineon sputum production[J]. Thorax, 1975, 30(5):543-547.
  24. 24. Burch JM, Denton JR, Noble RD. Physiologic rationale for abbre-viated laparotomy[J]. Surg Clin North Am, 1997, 77(4):779-782.
  25. 25. Sessler DI. Mild perioperative hypothermia[J]. N Engl J Med, 1997, 336(24):1730-1737.
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