儿童青少年1型糖尿病患者胃动力调查结果分析  

Survey of gastric emptying in children and adolescents with type 1 diabetes

作　　者：刘敏[1] 巩纯秀[1] 李铭[1] 曹冰燕[1] 

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《临床儿科杂志》2008年第12期1026-1029,共4页Journal of Clinical Pediatrics

基　　金：首都医学发展基金(No.2002-2005)

摘　　要：目的探讨不同病程1型糖尿病患儿胃动力变化及血糖对胃动力的影响。方法正常对照组(A组)24例。1型糖尿病组49例,其中B组为新诊断者28例,平均病程1.5个月;C组为病程3年以上者21例,平均病程6.3年。对上述对象做胃电图检查。糖尿病组进行钡条胃排空试验,同时测定空腹和餐后2h血糖。问卷调查消化道症状。结果问卷调查显示,B组仅1例有消化道症状(占3.6%),C组有消化道症状10例(占47.6%),两组差异有统计学意义(P=0.001)。B组有4例出现胃排空延迟,C组有1例,两组差异无统计学意义(P=0.54)。两组胃电图与正常对照组相比,餐前、餐后,胃窦、胃体振幅差异无统计学意义;B组胃体餐后频率低于A组(P<0.01);C组胃窦、胃体餐后频率均低于A组(P<0.05);B组胃窦餐前振幅低于C组(P<0.05)。未发现血糖水平、糖化血红蛋白(HbA1c)与胃排空、胃电参数的相关性(P>0.05)。结论糖尿病组尤其是长病程组消化道症状发生率显著高于正常对照组。儿童青少年1型糖尿病患者病程早期可见胃排空延迟,糖尿病患儿餐后胃电频率下降,提示儿童青少年1型糖尿病患者早期即可出现胃动力异常。Objectives To explore the changes of gastric emptying in children at the different stages of diabetes and effects of hyperglycemia on gastric emptying. Methods Twenty-four healthy children were studied as control （group A） . Forty-nine patients with type 1 diabetes were assigned into two groups： group B （new diagnosed group, n = 28） （average duration of disease was 1.5 months）, and group C （diabetic durations ≥ 3 years, n = 21） （average duration of disease was 6.3 years） . All subjects received electrogastrography （EGG） examination. Patients in group B and group C also received gastric emptying test with barium meal and measurement of fasting and 2 hours postprandial blood glucose levels. Symptom assessment was done by questionnaire. Results （1） There was one patient （3.6%） in group B, and 10 cases （47.6%） in group C with upper gastrointestinal symptoms, the difference between two groups was significant （P = 0.001）. （2） There were 4 patients （14.3%） in group B and 1 patient （4.8%） in group C who showed delayed gastric emptying, without significant difference between two groups （P = 0.54）. （3） There was no significant difference among three groups in pre-and postprandial gastric electrical amplitude both in gastric antrum and gastric body. Postprandial gastric electrical frequency in gastric body in group B was lower than in group A （P 〈 0.01 ）, Postprandial gastric electrical frequency both in gastric antrum and gastric body were lower in group C than that of group A （P 〈 0.05）. Postprandial gastric electrical frequency in gastric antrum was lower in group B than that of group C （P 〈 0.05）. （4） There was no significant correlation among fasting and postprandial （120 min） blood glucose, EGG parameters and delayed gastric emptying （P 〉 0.05） . Conclusions Gastric symptoms were more frequent in diabetic patients than in the normal control, and most frequent in patients with long-standing diabetes. Delayed gastric emptying

关 键 词：糖尿病 胃排空 胃轻瘫 胃电图 

分 类 号：R587.1[医药卫生—内分泌]