文章摘要
陈亚峰杨帆杨雁翎窦科峰陈勇△.胃转流术治疗非肥胖T2DM 术后1 年血糖代谢变化的研究[J].,2012,12(7):1335-1341
胃转流术治疗非肥胖T2DM 术后1 年血糖代谢变化的研究
A Study of One Year Change of Glucose Metabolism for Roux-en-Y GastricBypass in the Treatment of Non-Obese Type 2 Diabetes Mellitus
  
DOI:
中文关键词: 胃转流术  非肥胖  2 型糖尿病  回顾性研究
英文关键词: Roux-en-Y gastric bypass  Non-obese  Type 2 diabetes mellitus  Retrospective study
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作者单位
陈亚峰杨帆杨雁翎窦科峰陈勇△ 第四军医大学西京医院肝胆胰脾外科 
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中文摘要:
      目的:评价胃转流术(RYGP)治疗非肥胖2 型糖尿病(T2DM)的1 年血糖代谢变化,并探讨术前T2DM 病史对术后1 年效果 的影响。方法:收集我科2009 年6 月~2010 年4 月期间60 例行RYGP 的非肥胖T2DM 患者术前及术后1 年内的一般资料,临 床及实验室检查数据等。根据T2DM 病史分为两组: Ⅰ组:≤5 年;Ⅱ组:5-10 年,两组体质指数(BMI)均<30 kg/m2。术后6M、12M 主要随访:空腹血糖(FPG)、餐后2h 血糖(2hPG)、体重、BMI、糖化血红蛋白(HbA1c)、空腹血清胰岛素(Fins)、空腹C 肽(C-P)、胰 岛素抵抗指数和用药情况,采用SPSS17.0 软件进行手术前后对照与组间对照分析。结果:与术前相比,Ⅰ组术后6M、12M 时 FPG,2hPG,体重,BMI,C-P,HbA1c,Fins 均明显改善(P<0.05),HOMA-IR 在术后6M 无显著差异(P>0.05),术后12M 有显著差异 (P<0.05);Ⅱ组术后6M、12M 时与术前相比,FPG,2hPG,体重,BMI,C-P,HbA1c,HOMA-IR 均明显改善(P<0.05),Fins 在术后 6M、12M 与术前相比无显著差异(P>0.05)。Ⅰ组和Ⅱ组于术后6M、12M 在FPG、2hPG、体重、BMI、C 肽、Fins、HbA1c、HOMA-IR、 用药以及手术缓解率方面均无显著差异(P>0.05)。结论:非肥胖T2DM 患者胃转流术后1 年血糖代谢明显改善,术后完全缓解率 逐步增高,术前T2DM 病史(≤5 年与5-10 年)对术后1 年效果的影响无显著差异。
英文摘要:
      Objective: To investigate the one year change of glucose metabolism of Roux-en-Y gastric bypass (RYGP) in the treatment of non-obese type two diabetes mellitus (T2DM) patients and the effect of preoperative T2DM history on the one year operation effect through retrospective case control study. Methods: 60 patients diagnosed as type 2 diabetes by RYGP in our department from June 2009 to April 2010 were included in this study and the general materials, clinical and laboratory data of all the patients were collected. The patients were divided into two groups by preoperative history of T2DM: Ⅰgroup: less than five years; Ⅱgroup: five to ten years. The body mass index (BMI) of both groups were below 30 kg/m2. The follow-up data included fasting plasma glucose (FPG), 2h plasma glucose after oral glucose challenge (2hPG), weight, BMI, hemoglobin A1c (HbA1c), fasting C-peptide (C-P), fasting serum insulin (Fins), Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) and medication usage of T2DM in 6 months and 1 year postoperative, respectively, and the statistical analysis was performed by SPSS 17.0 software. Results: Compared with the preoperative data, FPG, 2hPG, weight, BMI, C-P, HbA1c and Fins of Ⅰgroup improved markedly (P< 0.05). HOMA-IR of the six months after surgery was no significant difference (P>0.05), whereas, there was significant difference in HOMA-IR of the one year after surgery (P< 0.05). In the Ⅱgroup, FPG, 2hPG, weight, BMI, C-P, HbA1c and HOMA-IR improved markedly compared with that in the preoperative (P< 0.05). Fins of the six months and one year were of no significant difference (P>0.05). There were no difference in six months and one year postoperative in FPG, 2hPG, weight, BMI, C-P, Fins, HbA1c, HOMA-IR, medications and rates of remission of operation between Ⅰ group and Ⅱ group (P>0.05). Conclusions: The glucose metabolism of one year after RYGP improved markedly in non-obese T2DM patients, the rates of complete remission after operation increased gradually and the influence of preoperative T2DM history (≤5 years and 5-10 years) on the one year effect was of no significantly difference.
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