胃转流手术对肥胖型成人隐匿性自身免疫糖尿病降糖效果的观察  

Effects of gastric bypass on latent autoimmune diabetes in adults

作　　者：张野[1] 高连中[1] 闫四梅[1] 贾元利[1] 

机构地区：[1]中国人民武装警察部队总医院普外科,北京100039

出　　处：《中国急救复苏与灾害医学杂志》2012年第12期1128-1130,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨胃转流术治疗肥胖型成人隐匿性自身免疫糖尿病（LADA）的临床疗效。方法11例肥胖型LADA患者接受胃转流术治疗，观察手术前后血糖，口服葡萄糖耐量试验（0GTT）、稳态模型胰岛素抵抗（HOMA—IR）、糖化血红蛋白（HbAIc）、的改变。结果11例患者术后1个月血糖均有明显下降，葡萄糖耐量试验明显增强（均P〈0．01），4例术后随访1年，血糖在正常范围，不需药物控制，患者7例术后6月，HOMA—IR、HbAIc显著低于手术前（均P〈0．01），糖尿病相关并发症均有不同程度缓解，3例手术后并发胃排空障碍，经保守治疗后痊愈。结论胃转流术能有效治疗肥胖型LADA，手术安全可行。Objective To evaluate the clinical therapeutic effects of gastric bypass （GBP） on obesitylatent autoimmune diabetes （LADA）. Methods Eleven patients with obesity-LADFA underwent GBP. The blood glucose concentrations, Oral glucose tolerance test （OGTT）, homeostasis model assessment insulin resistance index （HOMA-I）, and glycosylated hemoglobin （HbAIc）. Results The glucose concentrations of the 11 patients were dramatic decline, and their OGTT values were significantly higher one month after GBP （all P 〈 0.01）. 4 cases had been followed up for one year, although they did not take any drugs their glucose concentrations returned to normal （all P〈 0.01）. The levels of HOME-IR and HbAlc 6 months after GBP in 7 cases were significantly lower than those before GBP （all P〈0.01）. The symptoms of diabetes-related complications had been mitigated at different degrees. Three cases showed postoperative gastric emptying dysfunction, which was recovered after conservative treatment. Conclusion GBP is safe and effective in treating obesity-LADA.

关 键 词：成人隐匿性自身免疫糖尿病 胃转流术 

分 类 号：R587.2[医药卫生—内分泌]