2型糖尿病合并胃轻瘫患者血糖水平的临床观察  

Clinical observation of blood glucose levels in type 2 diabetes with gastroparesis

作　　者：魏剑芬[1] 陈冬[1] 吴乃君[1] 王颖[1] 马绍杰[1] 

机构地区：[1]河北联合大学附属医院内分泌科,唐山063000

出　　处：《中国糖尿病杂志》2015年第3期245-247,共3页Chinese Journal of Diabetes

摘　　要：目的观察T2DM合并胃轻瘫（T2DM＋胃轻瘫组）患者与单纯T2DM（T2DM组）患者不同时期血糖水平和胃排空率变化,探讨T2DM合并胃轻瘫患者血糖水平变化规律,为临床应用降糖药物提供时间调整依据。方法选取单纯T2DM组50例,T2DM＋胃轻瘫组50例,比较两组空腹及进食馒头餐150g后1hPG、2hPG、3hPG及4hPG水平变化。超声胃液体排空功能检查比较两组30、60、90、120及180min胃排空率。结果 T2DM＋胃轻瘫组FPG、4hPG高于T2DM组[FPG（12.56±3.48）vs（9.84±2.13）mmol/L;4hPG（15.26±4.87）vs（10.16±1.27）mmol/L]（P〈0.01）;T2DM＋胃轻瘫组1~3hPG水平低于T2DM组[1hPG（13.16±2.87）vs（16.58±2.64）mmol/L;2hPG（14.27±3.10）vs（19.86±4.34）mmol/L;3hPG（14.89±4.13）vs（16.86±2.17）mmol/L]（P均〈0.01）。T2DM＋胃轻瘫组各时间胃排空率低于T2DM组[30min（10.2±1.3）%vs（30.8±3.9）%;60min（17.9±2.3）%vs（38.8±3.5）;90min（30.1±4.1）%vs（56.8±6.1）%;120 min（47.9±5.6）%vs（78.9±7.6）%;180min（68.9±8.1）%vs（95.7±9.6）%]（P均〈0.01）。血糖水平与胃排空率呈正相关（r=0.75,P〈0.05）。结论 T2DM合并胃轻瘫患者胃排空率异常导致血糖水平的明显变化有时相特点,可为临床降糖药物给药时间调整提供理论依据,避免血糖波动过大。Objective To observe the characteristics of blood glucose levels and gastric emptying rate in different phases in T2DM with （T2DM＋gastroparesis group） and without gastroparesis （T2DM group） ,so as to provide evidence for the time adjustment in using hypoglycemic drugs. Methods 50 cases of pure diabetes and 50 cases of diabetic gastroparesis were selected in the study. Fasting glucose, 1 hPG,2 hPG,3 hPG,4 hPG after 150 gsteamed bread loading test were compared. Gastric emptying rate was tested by ultrasound examination of gastric juice empting at 30 min, 60 min, 90 min, 120 min, 180 rain. Results Fasting blood glucose（FPG）[（12. 56±3.48）mmol/L and 4 hPG（15. 26±4. 87）mmol/L] were significantly higher in T2DM＋ gastroparesis group than in T2DM group [FPG（9.84±2.13） mmol/L, and 4 hPG（10. 16±1.27）mmol/L]（all P〈0.01） ; 1 hPG[,（13.16±2.87） mmol/L], 2 hPG [,（14.27±3.12） mmol/L] and 3 hPG[,（14.89±4.13）mmol/L] were significantly lower in T2DM＋gastroparesis group than in T2DM group[1 hPG（16.58±2.64）retool/L, 2 hPG（19.86±4.34）mmol/L and 3 hPG（16.86±2.17）mmol/L, respectively] （all P〈0.01）. Gastric emptying rate in patients with diabetic gastroparesis at different time points [30 min （ 10. 2 ± 1.3） % ; 60 min （ 17.9±2.3） % ; 90 min（30.1 ±4.1） % ; 120 min （47.9±5.6）%;180 min （68. 9±8. 1）%] were all significantly lower than that of pure diabetic patients [30 min（30. 8±3.9）G;60 min（38. 8±3. 5）%; 90 min（56.8±6.1）%; 120 min（78.9±7.6）G; 180 min （95.7±9.6）% ] （all P〈0. 01）. The blood glucose was positively correlated with the rate of gastric emptying （r=0. 75,P〈0.05）. Conclusion The changes in blood glucose have phase characteristics due to the abnormal gastric emptying in diabetic patients with gastroparesis. These findings provide theoretical evidence for the time adjustment in administration of anti-diabetic drugs.

关 键 词：糖尿病 2型 胃轻瘫 血糖 

分 类 号：R587.2[医药卫生—内分泌]