迷走神经干切断术、选择性迷走神经切断术及高选择性迷走神经切断术对十二指肠溃疡患者糖耐量和胰岛素分泌的影响。第二部分——口服与静脉注射葡萄糖反应的比较
Effects of truncal, selective, and highly selective vagotomy on glucose tolerance and insulin secretion in patients with duodenal ulcer. Part II-Comparison of response to oral and intravenous glucose.
作者信息
Humphrey C S, Dykes J R, Johnston D
出版信息
Br Med J. 1975 Apr 19;2(5963):114-6. doi: 10.1136/bmj.2.5963.114.
Paired oral and intravenous glucose tolerance tests were carried out in patients who had undergone truncal vagotomy and pyloroplasty, selective vagotomy and pyloroplasty, or highly selective vagotomy at least six months earlier. Intravenous glucose tolerance was similar in all three groups. Oral glucose elicited significantly higher concentrations of plasma insulin in patients who had undergone selective and highly selective vagotomy than in those treated by truncal vagotomy. When the same amount of glucose was given intravenously, however, plasma insulin concentrations were similar in all three groups of patients. The insulin secreted in response to intravenous glucose expressed as a percentage of that secreted in response to oral glucose was 112% for truncal vagotomy, 51% for selective vagotomy, and 52% for highly selective vagotomy. Truncal vagotomy thus led to a diminished insulin response to oral glucose, which was probably due to impaired release of small-bowel hormones.
对至少在六个月前接受过胃迷走神经干切断术和幽门成形术、选择性迷走神经切断术和幽门成形术或高选择性迷走神经切断术的患者进行了口服和静脉葡萄糖耐量试验配对研究。三组患者的静脉葡萄糖耐量相似。口服葡萄糖后，接受选择性和高选择性迷走神经切断术的患者血浆胰岛素浓度明显高于接受胃迷走神经干切断术的患者。然而，当静脉注射等量葡萄糖时，三组患者的血浆胰岛素浓度相似。静脉注射葡萄糖后分泌的胰岛素占口服葡萄糖后分泌胰岛素的百分比，胃迷走神经干切断术组为112%，选择性迷走神经切断术组为51%，高选择性迷走神经切断术组为52%。因此，胃迷走神经干切断术导致对口服葡萄糖的胰岛素反应减弱，这可能是由于小肠激素释放受损所致。
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