Toda M, Sasaki I, Naito H, Funayama Y, Suzuki Y, Takahashi M, Matsuno S
First Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Nihon Geka Gakkai Zasshi. 1989 Nov;90(11):1879-89.
The effects of ileo-jejunal transposition (IJT) on gastro-intestinal hormones and intestinal structure have been studied in 9 mongrel dogs. IJT was performed by isoperistaltic interposition of the distal fourth of the small bowel in the jejunum 15 cm distal from the ligament of Treitz. A test meal (carbohydrate- and fat-rich) loading was carried out in 5 dogs before and 4 and 12 weeks after the operation. Plasma concentrations of gastrointestinal hormones (GLI, GI, GIP and gastrin) were measured by radioimmunoassay using the antibodies. The six mongrel dogs were used for the histological studies. Following IJT hyperenteroglucagonemia was observed, especially in postprandial state. An increase of the mucosal thickness in the whole intestine was observed after IJT. This suggested the possibility that enteroglucagon stimulates intestinal mucosal growth as a circulating hormone. Postprandial plasma GIP levels after IJT were significantly lower at the 90, 120 and 150 min after the test meal loading than those of the preoperative state. Plasma gastrin levels were no significant differences before and after surgery. These observations lead us to conclude that enteroglucagon may play an important role in intestinal adaptation mechanisms after IJT.
在9只杂种犬身上研究了回肠-空肠转位术(IJT)对胃肠激素和肠道结构的影响。IJT通过将小肠远端四分之一以等蠕动方式插入距屈氏韧带15厘米远的空肠来实施。对5只犬在手术前以及术后4周和12周进行富含碳水化合物和脂肪的试餐负荷试验。使用抗体通过放射免疫分析法测量胃肠激素(胰高血糖素样免疫活性物质、胃抑肽、葡萄糖依赖性促胰岛素多肽和胃泌素)的血浆浓度。6只杂种犬用于组织学研究。IJT后观察到高肠高血糖素血症,尤其是在餐后状态。IJT后观察到整个肠道黏膜厚度增加。这提示肠高血糖素作为一种循环激素刺激肠道黏膜生长的可能性。IJT后试餐负荷后90、120和150分钟时餐后血浆葡萄糖依赖性促胰岛素多肽水平显著低于术前状态。手术前后血浆胃泌素水平无显著差异。这些观察结果使我们得出结论,肠高血糖素可能在IJT后的肠道适应机制中起重要作用。