糖尿病患者胆囊排空功能障碍40例  

Gallbladder emptying dysfunction in diabetic patients: an analysis of 40 cases

作　　者：卢丽君[1] 严祥[2] 马苏美[1] 

机构地区：[1]兰州大学第一医院超声医学科,甘肃省兰州市730000 [2]兰州大学第一医院,甘肃省兰州市730000

出　　处：《世界华人消化杂志》2011年第3期301-304,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨糖尿病患者胆囊排空功能的改变及其发生机制.方法:B超测定24例糖尿病合并自主神经病变患者(AN组)、16例不合并自主神经病变患者(NAN组)及20例正常对照组空腹胆囊体积、胆囊动脉血流及脂餐后胆囊的排空功能.结果:AN组较NAN组及正常组空腹胆囊体积明显增大(22.71mL±6.67mLvs14.39mL±5.10mL,15.49mL±4.66mL,均P<0.01),餐后各时点胆囊体积也显著增大(P<0.01),各时点胆囊排空率明显减低(P<0.01);AN组胆囊动脉血流参数阻力指数(RI)较NAN组及正常组明显升高(0.74±0.07vs0.65±0.05,0.61±0.06,均P<0.01),而舒张期最低流速(Vmin)较NAN组及正常组明显降低(5.62±1.19vs8.31±1.86,8.72±1.43,均P<0.01);胆囊动脉RI与糖化血红蛋白及胰岛素抵抗指数(Homa-IR)显著相关(r=0.648,0.822,P<0.05).结论:糖尿病患者胆囊排空功能明显减低与自主神经受损有关;糖尿病合并自主神经病变时其胆囊动脉RI和Vmin较NAN组及正常组有明显差异,糖尿病胆囊动脉血管病变也是影响胆囊排空功能的重要原因.AIM： To explore the mechanisms underlying gallbladder emptying dysfunction in diabetic patients. METHODS： Gallbladder volume and gallblad- der arterial blood flow were measured on an empty stomach and gallbladder emptying after a fatty meal was measured by B-mode ultrasound in 24 diabetic patients with autonomic neuropathy （AN group）, 16 diabetic patients without autonomic neuropathy （NAN group）, and 20 healthy controls （HC group）. RESULTS： Fasting gallbladder volume increased more significantly in the AN group than in the HC group and NAN group （22.71 mL ± 6.67 mL vs 14.39 mL ± 5.10 mL, 15.49 mL ± 4.66 mL, both P 〈 0.01）. Postprandial gallbladder volume significantly increased at all time points （all P 〈 0.01）, while the rate of gallbladder emptying at all time points was significantly lower in the AN group than in the other two groups （all P 〈 0.01）. Gallbladder arterial resistance index （RI） was significantly higher in the AN group than in the other two groups （0.74 ± 0.07 vs 0.65 ± 0.05, 0.61 ± 0.06, both P 〈 0.01）. The minimum diastolic blood flow velocity （Vmin） was significantly lower in the AN group than in the other two groups （5.62 ± 1.19 vs 8.31 ± 1.86, 8.72 ± 1.43, both P 〈 0.01）. Gallbladder arterial RI showed a significant correlation with glycosylated hemoglobin level and insulin resistance index （HOMA-IR） （r =0.648, 0.822, both P 〈 0.05）. CONCLUSION： The development of gallbladder emptying dysfunction in diabetic patients is partly due to impaired autonomic nerve. There are significant differences in gallbladder arterial RI and Vmin among the AN group, NAN group and HC group. Gallbladder emptying dysfunction may be associated with hemodynamic changes in the gallbladder.

关 键 词：糖尿病 胆囊排空 动脉 超声检查 

分 类 号：R587.1[医药卫生—内分泌]