【摘要】 目的 探讨胃转流手术后(GBP)糖代谢与胰高血糖素样肽-1GLP-1的变化规律。 方法 选取SD大鼠30只，随机分为5组，术后4周时检测OGTT，ELISA检测血浆总GLP-1的表达。 结果 与Ⅰ组术前相比，各实验组术后OGTT各时间点血糖水平均明显下降(P<0.05);与Ⅱ组术前相比，Ⅲ、Ⅳ、Ⅴ组术后血糖水平差异无统计学意义(P>0.05);与Ⅰ组血浆总GLP-1值[空腹(42.7 ±4.9)pmol/L，餐后(47.5 ±7.9) pmol/L]相比，Ⅱ、Ⅲ、Ⅳ、Ⅴ组空腹和餐后30 min血浆总GLP-1值上升(P<0.05);与Ⅱ组血浆总GLP-1值[空腹(54.0 ±6.5)pmol/L，餐后(75.1 ±13.8)pmol/L)]相比，Ⅲ、Ⅳ、Ⅴ组空腹和餐后30 min血浆总GLP-1值均呈上升趋势，餐后30 min血浆总GLP-1表达明显上升(P分别为0.01、0.000、0.000);⑤与Ⅲ组血浆总GLP-1[空腹(54.0 ±6.5)pmol/L，餐后(75.1 ±13.8)pmol/L)]相比，随着转流肠襻长度的增加，Ⅳ、Ⅴ组空腹和餐后30 min血浆总GLP-1表达逐渐升高，Ⅴ组餐后30 min血浆总GLP-1表达明显上升 (P=0.01)。 结论 肠道GLP-1表达的最佳效应区域位于小肠中段，GBP对T2DM 的治疗作用与术后血浆GLP-1水平上调相关，是手术治疗糖尿病的机制之一。

　　【关键词】 胃转流手术;糖尿病，2型;糖代谢;胰高血糖素样肽-1

　　Experimental study on the SD rats to observe the change of glucose and GLP-1 levels after gastric bypass ZHANG Xiao-mei, GAO Hong-kai, SHI Hong-zhi, et al. Dandong The First Hospital, Liaoning 118000, China

　　Corresponding author: GAO Hong-kai, E-mail: wjgaohk@163.com

　　【Abstract】Objective To establish the stomach-preserving Roux-en-Y gastric bypass model in SD rats and investigate the changing laws of glucose metabolism and glucagon-like peptide-1 (GLP-1) level after surgery. Methods Thirty SD rats were randomized into 5 groups: group I (sham operation), groupⅡ (traditional bypass ), group Ⅲ (duodenum bypass), group Ⅳ (jejunum bypass), group Ⅴ (ileum bypass). OGTT and total plasma GLP-1 expression were evaluated before and 4 weeks after operation for observation. Results ① Compared with group I, the blood glucose level in the experimental groups dropped significantly at all OGTT time points after surgery. ② Compared with group Ⅱ, the change in blood glucose level in the group Ⅲ, Ⅳ, and Ⅴ was not statistically significant after surgery (P>0.05). ③ Compared with the total plasma GLP-1 expression in group I [fasting (42.7±4.9) pmol/L, after meal (47.5±7.9) pmol/L], the total plasma GLP-1 expression in group Ⅱ, Ⅲ, Ⅳ, and Ⅴ increased at fasting and 30 min after meal (P<0.05). ④ Comparing with the total plasma GLP-1 expression in group Ⅱ [fasting (54.0±6.5) pmol/L, after meal (75.1±13.8) pmol/L], the total plasma GLP-1 expression in group Ⅲ, Ⅳ, and Ⅴ increased at fasting and 30 min after meal, especially in 30 min after meal (P=<0.01, 0.000, and 0.000 respectively). ⑤ Comparing with the total plasma GLP-1 expression in group Ⅲ [fasting (54.0±6.5) pmol/L, after meal (75.1±13.8) pmol/L], the total plasma GLP-1 expression in group Ⅳ and Ⅴ increased gradually at fasting and 30 min after meal owing to the increased length of intestinal loop, especially in group Ⅴ at 30 min after meal (P=0.01). Conclusions The effective section of GLP-1 expression in gut locates in the middle part of small intestine, and the remission effect of GBP on T2DM is associated with increased GLP-1 expression, being one of the mechanisms of operative treatment for diabetes.

　　【Key words】Diabetes mellitus, type 2; Gastric bypass surgery; Glucagon-like peptide 1 (GLP-1)