袖状胃切除术联合十二指肠空肠旁路术的研究进展  

Research advances in sleeve gastrectomy with duodenojejunal bypass

作　　者：罗世锦 董世梁 王存川[2] 董志勇[2] Luo Shijin;Dong Shiliang;Wang Cunchuan;Dong Zhiyong(School of Medicine,Jinan University,Guangzhou 510632,China;Department of Metabolic and Bariatric Surgery/Bariatric Center,The First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学基础医学与公共卫生学院,广州510632 [2]暨南大学附属第一医院胃肠外科/减重中心,广州510630

出　　处：《中华肥胖与代谢病电子杂志》2022年第4期271-276,共6页Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition

摘　　要：近年来,基于袖状胃切除术联合近端小肠手术是研究热点之一。据目前研究报道,袖状胃切除术联合十二指肠空肠旁路术(SG-DJB)的减重效果比袖状胃切除术(SG)和Roux-en-Y胃旁路术(RYGB)更显著,且降血糖效果能与RYGB相媲美。有研究报道SG-DJB通过食物支的重构,诱导食物支的上皮细胞肥大促进葡萄糖的消耗,使血糖水平下降。且ABCD评分(包括年龄、BMI、血清C肽水平、糖尿病病程时长)小于5的患者的降血糖效果更佳。目前研究认为减重手术的降糖机制与胰岛素抵抗和慢性低度炎症有关,但SG-DJB流行时间短,缺乏临床相关研究证据,其缓解T2DM的机制仍未清楚。In recent years,sleeve gastrectomy plus surgery is one of the research hotspots.According to current studies,sleeve gastrectomy with duodenojejunal bypass(SG-DJB)has a more significant weight loss effect than sleeve gastrectomy(SG)and Roux-en-Y gastric bypass(RYGB),and the hypoglycemic effect is comparable to RYGB.Studies have reported that SG-DJB through the reconstructionof the alimentary limb,induced hypertrophy of epithelial cells of the alimentary limb promotes glucose depletion,and lowers blood glucose levels.And patients with ABCD score(includes age,body mass index,serum C-peptide level,and duration of diabetes)of less than 5 had a better hypoglycemic effect.Current studies suggest that the hypoglycemic mechanism of bariatric surgery is related to insulin resistance and chronic low-grade inflammation.However,SG-DJB has a short prevalence time and lacks clinical evidence,and its mechanism of alleviating T2DM remains unclear.

关 键 词：袖状胃切除术 袖状胃切除术联合十二指肠空肠旁路术 2型糖尿病 肥胖症 ROUX-EN-Y胃旁路术 减重手术 糖代谢 

分 类 号：R58[医药卫生—内分泌]