腹腔镜Roux-en-Y胃转流术对2型糖尿病患者术后近期血压的影响  

Effects of laparoscopic Roux-en-Y gastric bypass on early postoperative blood pressure in patients with type 2 diabetes

作　　者：杨建江[1] 倪银星[1] 何洪波[1] 钟健[1] 赵志钢[1] 陈静[1] 孙芳[1] 郑洲[1] 宋嫒嫒[1] 闫振成[1] 童卫东[2] 祝之明[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所:高血压内分泌科全军高血压代谢病中心重庆市高血压研究所,400042 [2]第三军医大学大坪医院野战外科研究所胃结直肠外科,重庆400042

出　　处：《第三军医大学学报》2013年第9期828-831,共4页Journal of Third Military Medical University

基　　金：重庆市科委国际科技合作基金科技平台与基地建设项目(CSTC2011gjhz10002);第三军医大学校管临床科研课题(2009XLC30、2010XLC38);国家重点基础研究发展计划(973计划,2012CB517805)~~

摘　　要：目的评价腹腔镜Roux-en-Y胃转流术(Roux-en-Y gastric bypass,RYGB)对2型糖尿病(type 2 diabetesmellitus,T2DM)患者近期血压的影响。方法分析2010年5月至2012年4月经内科评估后行腹腔镜RYGB的T2DM患者21例的临床资料,包括手术前及术后1、3、6、12个月诊室血压、24 h动态血压(24-hour ambulatory blood pressure,ABPM)等的变化情况,及其与体质量、体质指数(BMI)、腰围(WC)的关系。结果肥胖组(BMI≥28.0 kg/m2)手术后能明显降低患者诊室血压和晨峰血压(MBPS)(P<0.05);非肥胖组仅舒张压手术前后有统计学差异(P<0.05),ABPM各指标无统计学差异。与术前相比,合并高血压患者诊室血压显著下降(P<0.05),且与手术前后体质量、BMI、WC及其变化均无显著相关。结论腹腔镜RYGB能够有效降低2型糖尿病合并高血压患者术后近期血压,且血压下降与体质量、BMI、WC无显著相关。Objective To determine the effect of laparoscopic Roux-en-Y gastric bypass on blood pressure in patients with type 2 diabetes. Methods Clinical data of 21 cases of patients with T2DM undergo- ing Roux-en-Y gastric bypass in our department ＇after medical assessment during 2010 to 2012 were collected in this study. Their office blood pressure and 24-hour ambulatory blood pressure （ABPM） before and in 1, 3, 6, and 12 months after surgery were recorded, and the correlation between their changes with body weight, body mass index （BMI） , waist eireunrferenee （WC） were analyzed. Results Compared with pre-operation, the office blood pressure and morning blood pressure surge （MBPS） were deereased significantly （P 〈0.05） in the obese group （BMI I〉28.0 kg/m2）. In non-obese group only the diastolic blood pressure was decreased after surgery. （ P 〈 0.05 ） , and had no significant difference in ABPM before and after surgery. Compared with pre- operation, office blood pressure was deereased significantly in patients with both T2DM and hypertension （P 〈 0.05）. Moreover, there was no signifieant correlation between the changes of office blood pressure and the changes of body weight, BMI, and WC before and after operation. Gonclusion For T2DM patients with hypertension, laparoseopie Roux-en-Y gastric bypass decreases the early post-operative blood pressure signifi- cantly, and there is no significant correlation between the changes of blood pressure and the changes of body weight, BMI, and WC.

关 键 词：2型糖尿病 胃转流术 血压 

分 类 号：R544[医药卫生—心血管疾病] R587.105[医药卫生—内科学]