原发性肝癌合并糖尿病手术前后胃泌素和胃动素水平的变化  

Changes of Gastrin and Motilin for Patients with Hepatocellular Carcinoma Complicated with Diabetes Mellitus before and after Operation

作　　者：刘滨伟[1] 刘博伟[2] 刘俊茹[2] 李芳凝[3] 

机构地区：[1]秦皇岛市第一医院普外科,河北秦皇岛066000 [2]秦皇岛市第一医院内分泌科,河北秦皇岛066000 [3]秦皇岛市第一医院口腔科,河北秦皇岛066000

出　　处：《中国普外基础与临床杂志》2011年第10期1087-1090,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨糖尿病对原发性肝癌(HCC)手术治疗前、后胃肠激素水平变化的影响。方法选取2007年4月至2010年2月期间我院收治的择期手术治疗的HCC患者143例,其中合并糖尿病者43例(DM组),不合并糖尿病者100例(NDM组),测定术前3d及术后1、2及7d血胃泌素(GAS)和胃动素(MTL)水平。结果①2组患者术后1、2及7d血浆MTL水平较术前明显下降(P<0.05),血浆GAS水平较术前明显升高(P<0.05)。②与NDM组相比,DM组术前血浆MTL和GAS水平均高于NDM组(P<0.05),术后1、2及7d血浆MTL水平降低更明显(P<0.05),GAS水平升高也更明显(P<0.05)。③NDM组术后首次肛门排气时间明显早于DM组(P<0.05)。④DM组病史≥10年、空腹血糖≥10mmol/L者首次肛门排气时间较病史<10年、空腹血糖<10mmol/L者明显延长(P<0.05)。结论糖尿病影响HCC切除术后的血GAS、MTL水平变化,糖尿病病程长及血糖控制不佳加重术后GAS、MTL水平的变化,使术后胃肠功能恢复延迟。Objective To discuss the effects of diabetes mellitus（DM） on gastrointestinal hormone changes before and after hepatocellular carcinoma（HCC） operation. Methods The clinical data of 143 patients with HCC treated in this hospital from April 2007 to Febuary 2010 were analyzed,which 43 patients with DM（DM group） and 100 patients without DM（NDM group）.Gastrin（GAS） and motilin（MTL） levels were measured on day 3 before operation and on day 1,2,and 7 after operation. Results ① The blood MTL levels decreased and GAS levels increased on day 1,2,and 7 after operation as compared with the levels before operation（all P0.05）.② The blood MTL level and GAS level before operation in the DM group was higher than that in the NDM group（P0.05）,MTL level decreased while GAS level increased more significantly on day 1,2,and 7 after operation（P0.05）.③ The first anus exhausting time of patients with NDM was much earlier than that with DM（P0.05）.④ The first anus exhausting time with DM over 10 years and fasting plasma glucose over 10 mmo1/L was obviously extended（P0.05）. Conclusion DM affectes GAS and MTL level changes after HCC operation,recovery of gastrointestinal function would be delayed if patients with long course of DM and poor control of plasma glucose.

关 键 词：糖尿病 原发性肝癌 胃泌素 胃动素 

分 类 号：R735.7[医药卫生—肿瘤] R587.1[医药卫生—临床医学]