Buchan A M, Pederson R A, Koop I, Gourlay R H, Cleator I G
Department of Physiology, University of British Columbia, Vancouver, Canada.
Int J Obes Relat Metab Disord. 1993 Feb;17(2):109-13.
The effect of ileo-gastrostomy on insulin and cholecystokinin secretion and the endocrine cells containing cholecystokinin, somatostatin, motilin, secretin, neurotensin and enteroglucagon was studied. Fasting and postprandial plasma samples collected pre- and post-operation demonstrated significant changes in circulating insulin and cholecystokinin. Fasting and postprandial insulin levels decreased three months after ileo-gastrostomy (postprandial pre-operation 40 +/- 8 microU/ml compared to 15 +/- 24 microU/ml post-operation, P < 0.02). The postprandial levels of cholecystokinin were significantly increased (pre-operation 7.1 +/- 1.1 pg/ml compared to 12.2 +/- 1.7 pg/ml post-operation, P < 0.02). Quantification of the endocrine cell populations in the jejunum in-continuity three months after ileo-gastrostomy demonstrated an hyperplasia of cholecystokinin-, secretin-, gastric inhibitory polypeptide-, motilin- and somatostatin-containing cells. In samples of the ileum taken from within the bypass loop the neurotensin- and somatostatin-containing cells were unaffected while the enteroglucagon-containing cells were significantly increased in number. Ileo-gastrostomy resulted in significant alterations to the abundance of regulatory peptide-containing endocrine cells and to circulating levels of insulin and cholecystokinin. These changes are implicated in the dramatic weight loss associated with the operation.
研究了回肠-胃造口术对胰岛素和胆囊收缩素分泌以及含胆囊收缩素、生长抑素、胃动素、促胰液素、神经降压素和肠高血糖素的内分泌细胞的影响。术前和术后采集的空腹及餐后血浆样本显示，循环胰岛素和胆囊收缩素发生了显著变化。回肠-胃造口术后三个月，空腹和餐后胰岛素水平下降（术前餐后为40±8微单位/毫升，术后为15±24微单位/毫升，P<0.02）。胆囊收缩素的餐后水平显著升高（术前为7.1±1.1皮克/毫升，术后为12.2±1.7皮克/毫升，P<0.02）。回肠-胃造口术后三个月，对连续空肠段内分泌细胞群进行定量分析，结果显示含胆囊收缩素、促胰液素、胃抑制多肽、胃动素和生长抑素的细胞增生。在取自旁路肠袢内的回肠样本中，含神经降压素和生长抑素的细胞未受影响，而含肠高血糖素的细胞数量显著增加。回肠-胃造口术导致含调节肽的内分泌细胞数量和胰岛素及胆囊收缩素的循环水平发生显著改变。这些变化与该手术相关的显著体重减轻有关。
