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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.

DOI:10.1136/bmj.2.5963.114
PMID:1125699
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1673070/
Abstract

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.

摘要

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。

相似文献

1
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.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
Br Med J. 1975 Apr 19;2(5963):114-6. doi: 10.1136/bmj.2.5963.114.
2
Effects of truncal, selective, and highly selective vagotomy on glucose tolerance and insulin secretion in patients with duodenal ulcer. Part I-Effect of vagotomy on response to oral glucose.迷走神经干切断术、选择性迷走神经切断术和高选择性迷走神经切断术对十二指肠溃疡患者糖耐量及胰岛素分泌的影响。第一部分——迷走神经切断术对口服葡萄糖反应的影响。
Br Med J. 1975 Apr 19;2(5963):112-4. doi: 10.1136/bmj.2.5963.112.
3
Effects of selective gastric vagotomy and pyloroplasty on oral and intravenous glucose tolerance and insulin secretion.选择性胃迷走神经切断术和幽门成形术对口服及静脉葡萄糖耐量和胰岛素分泌的影响。
Arch Surg. 1976 Aug;111(8):850-3. doi: 10.1001/archsurg.1976.01360260018003.
4
Release of gastric inhibitory polypeptide and insulin in response to intrajejunal glucose in duodenal ulcer patients before and after truncal vagotomy.十二指肠溃疡患者在迷走神经切断术前、后空肠内注入葡萄糖后胃抑制性多肽和胰岛素的释放情况。
Scand J Gastroenterol. 1982 Jun;17(4):507-11. doi: 10.3109/00365528209182240.
5
Incidence of dumping after truncal and selective vagotomy with pyloroplasty and highly selective vagotomy without drainage procedure.行胃大部切除加幽门成形术的迷走神经干切断术和选择性迷走神经切断术后以及未行引流手术的高选择性迷走神经切断术后倾倒综合征的发生率。
Br Med J. 1972 Sep 30;3(5830):785-8. doi: 10.1136/bmj.3.5830.785.
6
[Study of blood sugar and insulin after vagotomy and pyloroplasty in man].[人体迷走神经切断术和幽门成形术后血糖及胰岛素的研究]
Ann Endocrinol (Paris). 1969 Jan-Feb;30(1):96-102.
7
[Oral glucose tolerance after selective proximal vagotomy with pyloroplasty (author's transl)].选择性近端迷走神经切断术加幽门成形术后的口服葡萄糖耐量(作者译)
MMW Munch Med Wochenschr. 1974 May 3;116(18):929-32.
8
Proceedings: A controlled comparison of highly selective vagotomy against truncal vagotomy and pyloroplasty for duodenal ulcer.论文集:高选择性迷走神经切断术与迷走神经干切断术加幽门成形术治疗十二指肠溃疡的对照比较
Gut. 1975 Oct;16(10):829.
9
Bile acid and lysolecithin concentrations in the stomach in patients with duodenal ulcer before operation and after treatment by highly selective vagotomy, partial gastrectomy, or truncal vagotomy and drainage.十二指肠溃疡患者在手术前以及经高选择性迷走神经切断术、胃部分切除术或迷走神经干切断术加引流术治疗后的胃内胆汁酸和溶血卵磷脂浓度。
Gut. 1982 Jul;23(7):569-77. doi: 10.1136/gut.23.7.569.
10
Vagal control of glucagon release in man.迷走神经对人体胰高血糖素释放的控制。
Lancet. 1974 Sep 7;2(7880):546-9. doi: 10.1016/s0140-6736(74)91875-3.

引用本文的文献

1
Characterisation of oral and i.v. glucose handling in truncally vagotomised subjects with pyloroplasty.研究经毕罗氏胃切除术的横断性迷走神经切断术后患者口服和静脉内葡萄糖处理的特点。
Eur J Endocrinol. 2013 Jul 6;169(2):187-201. doi: 10.1530/EJE-13-0264. Print 2013 Aug.
2
Effect of vagotomy on gastrointestinal hormones.迷走神经切断术对胃肠激素的影响。
World J Surg. 1979 Sep 20;3(5):615-22. doi: 10.1007/BF01654771.

本文引用的文献

1
The effect of vagotomy on the glucose tolerance of patients with peptic ulceration.迷走神经切断术对消化性溃疡患者糖耐量的影响。
Gastroenterology. 1951 Jun;18(2):230-4.
2
PLASMA INSULIN RESPONSE TO ORAL AND INTRAVENOUS GLUCOSE ADMINISTRATION.血浆胰岛素对口服和静脉注射葡萄糖的反应。
J Clin Endocrinol Metab. 1964 Oct;24:1076-82. doi: 10.1210/jcem-24-10-1076.
3
CONTRACTION OF THE GALL BLADDER BEFORE AND AFTER TOTAL ABDOMINAL VAGOTOMY.全腹迷走神经切断术前及术后胆囊的收缩情况
Clin Radiol. 1964 Oct;15:350-4. doi: 10.1016/s0009-9260(64)80014-3.
4
HYPOGLYCEMIC VAGAL STIMULATION AND THE INTESTINAL PHASE OF GASTRIC SECRETION.低血糖性迷走神经刺激与胃分泌的肠期
J Surg Res. 1964 Sep;4:391-4. doi: 10.1016/s0022-4804(64)80110-4.
5
AN INTESTINAL HORMONE AFFECTING GLUCOSE DISPOSAL IN MAN.一种影响人体葡萄糖代谢的肠道激素。
Lancet. 1964 Sep 26;2(7361):672-3. doi: 10.1016/s0140-6736(64)92481-x.
6
THE EFFECT OF EXTRAGASTRIC VAGOTOMY ON HEIDENHAIN-POUCH SECRETION IN DOGS.胃外迷走神经切断术对犬海登海因小胃分泌的影响
Am J Dig Dis. 1964 Apr;9:256-62. doi: 10.1007/BF02232130.
7
EFFECTS OF VAGAL-NERVE SECTION ON THE BILIARY SYSTEM.迷走神经切断术对胆道系统的影响
Lancet. 1964 Mar 14;1(7333):579-81. doi: 10.1016/s0140-6736(64)91330-3.
8
Immunoassay of insulin with insulin-antibody precipitate.用胰岛素 - 抗体沉淀物进行胰岛素免疫测定。
Biochem J. 1963 Jul;88(1):137-46. doi: 10.1042/bj0880137.
9
Inhibitory effect of pancreatic secretin on gastric secretion.胰泌素对胃液分泌的抑制作用。
Am J Physiol. 1957 Sep;190(3):396-402. doi: 10.1152/ajplegacy.1957.190.3.396.
10
Interpretation of the rapid intravenous glucose tolerance test in normal individuals and in mild diabetes mellitus.正常个体及轻度糖尿病患者快速静脉葡萄糖耐量试验的解读
J Clin Invest. 1953 May;32(5):428-35. doi: 10.1172/JCI102755.