摘要
目的探讨术前口服碳水化合物对胃癌术后胰岛素抵抗的影响。方法选取行胃癌根治术(D2)的病人40例,随机分为2组。试验组术前3h口服碳水化合物(葡萄糖溶液),对照组术前3h口服安慰剂(清水)。分别比较两组病人术前及术后血糖、胰岛素、胰岛素抵抗指数(HOMA-IR),以及胰高血糖素样肽-1(GLP-1)、超氧化物歧化酶(SOD)和丙二醛(MDA)的水平。结果术前两组病人空腹血糖、胰岛素、HOMA-IR以及SOD、MDA水平比较差异均无显著性(P>0.05),试验组GLP-1水平较对照组明显升高(t=5.97,P<0.05)。与对照组相比,试验组术后空腹血糖、胰岛素、HOMA-IR及MDA水平降低,SOD水平升高,差异均有统计学意义(t=5.08～19.39,P<0.01)。结论术前口服碳水化合物可以刺激胃癌病人产生GLP-1以保护胰腺,增强胰岛素分泌能力,并且减轻病人的氧化应激,从而改善病人术后的胰岛素抵抗水平。
Objective To investigate the influence of preoperative oral carbohydrate on insulin resistance after surgery for gastric cancer. Methods Forty patients scheduled for radical gastrectomy were evenly randomized to two groups. Three hours before surgery, the patients in experimental group were given oral carbohydrate （glucose solution）, and those in control group wa ter was given. The levels of blood glucose, insulin and the index of insulin resistance （HOMA-IR）, of GLP-1 and SOD, MDA were measured （before and after surgery） and compared between the two groups. Results Before operation, the levels of fasting blood sugar, insulin, HOMA IR, SOD and MDA between the two groups were not significantly different （P〉0.05）, while GI.P 1 level in the experimental group was higher versus the control （t 5.97 ,P〈0.05） ; After surgery, the levels of blood glucose, in- sulin, insulin resistance, and SOD index were higher in the experimental group than the control （t = 5.08-19.39, P〈0.01）. Conclusion Preoperative oral carbohydrate can stimulate the production of GLP-1 in patients with gastric cancer, enhance the secretion of insulin, and relieve patient＇s oxidative stress, and thus improve postoperative insulin resistance.
出处
《齐鲁医学杂志》
2013年第4期302-304,共3页
Medical Journal of Qilu
关键词
碳水化合物
胃肿瘤
外科手术
胰岛素抗药性
氧化性应激
carbohydrates
stomach neoplasms
surgical procedures, operative
insulin resistance
oxidative stress
作者简介
王智浩（1985-），男，在读硕士研究生。
[通讯作者]周岩冰（1964-），男，硕士，主任医师，博士生导师。
