胃大部分切除术后消化道重建对2型糖尿病患者脂肪因子紊乱的影响

发布时间：2018-06-24 05:10

  本文选题：型糖尿病 + 胃大部分切除术　； 参考：《广东医学》2016年20期

【摘要】：目的观察胃大部分切除术后消化道重建对肥胖型2型糖尿病(T2DM)的疗效,及其对机体网膜素-l(Omentin-1)、爱帕琳肽(Apelin)和内脏脂肪素(Visfatin)水平的影响。方法选择行胃大部分切除术的T2DM患者98例,根据胃大部分切除术消化道重建方式不同分为观察组(56例)和对照组(42例),观察组为roux-end-Y吻合术,对照组为毕I式吻合。观察两组治疗后对血糖控制的疗效,及治疗前后空腹血糖(FPG)、餐后2 h血糖(2h PBG)、糖化血红蛋白(Hb A1C)、空腹胰岛素(Fins)、餐后胰岛素(2h Ins)、Omentin-1、Apelin和Visfatin水平的变化。结果观察组的疗效为85.71%,明显优于对照组的64.29%,差异有统计学意义(x2=5.762,P0.05)。两组治疗前的FPG、2h PBG、Hb A1C、FIns、2h Ins、HOMA-IR、HOMA-β、Omentin-1、Apelin和Visfatin水平差异无统计学意义(P0.05),治疗后两组的FPG、2Hpbg、Hb A1C、FIns、2h Ins、HOMA-IR、Apelin和Visfatin水平均较治疗前明显降低(P0.01),HOMA-β和Omentin-1水平较治疗前明显升高(P0.01),而观察组的降低或者升高水平较对照组更为明显(P0.01)。结论胃大部分切除行roux-end-Y消化道重建控制T2DM的疗效优于毕I式吻合,可提高机体胰岛素的敏感性,缓解机体胰岛素抵抗,可能与改善机体的脂肪因子紊乱有关。
[Abstract]:Objective to observe the effect of alimentary tract reconstruction after subtotal gastrectomy on obese type 2 diabetes mellitus (T2DM) and its effects on the levels of omentin-l (Omentin-1), epalineptide (Apelin) and visceral adipotin (visfatin) in obese type 2 diabetes mellitus (T2DM). Methods 98 patients with T2DM underwent subtotal gastrectomy were divided into observation group (n = 56) and control group (n = 42). The observation group was roux-end-Y anastomosis and the control group was Bii anastomosis. The changes of fasting blood glucose (FPG), postprandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1C), fasting insulin (fins), postprandial insulin (2h ins), Omentin-1 apelin and Visfatin were observed before and after treatment. Results the curative effect of the observation group was 85.71, which was significantly better than that of the control group (64.29 vs 64.29, P 0.05). There was no significant difference in the levels of HBMA- 尾 Omentin-1Apelin and Visfatin between the two groups before and after treatment (P0.05). After treatment, the levels of FPGG 2HpbgHbA1CFFIns1InsHOMA-Apelin and Visfatin were significantly lower than those before treatment (P0.01), and the levels of Omentin-尾 and Omentin-1 were significantly higher than those before treatment (P0.01), while the levels of Omentin-1 and HOMA- 尾 in the observation group were significantly higher than those before treatment (P0.01). The level was significantly higher than that in the control group (P0.01). Conclusion the effect of roux-end-Y reconstruction of digestive tract in the control of T2DM is better than that of Bii anastomosis. It can improve the insulin sensitivity and alleviate the insulin resistance, which may be related to the improvement of the disorder of fat factor in the body.
【作者单位】： 同济大学医学院;上海市浦东新区周浦医院普外科;
【分类号】：R587.1;R656.6
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本文编号：2060170