胃旁路术治疗不同体重指数2型糖尿病效果评价  被引量:4

Effects of gastric bypass surgery on type 2 diabetes mellitus patients with different body mass index

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作  者:李会齐[1] 郝福军 葸根 陈海伟[1] 

机构地区:[1]陕西省宝鸡市人民医院普外科,721000

出  处:《中华内分泌外科杂志》2015年第3期201-203,226,共4页Chinese Journal of Endocrine Surgery

摘  要:目的:探讨胃旁路术( gastric bypass,GBP)治疗不同体重指数( body mass index,BMI)的2型糖尿病(type 2 diabetes mellitus,T2DM)的临床效果。方法将宝鸡人民医院2012年9月至2013年7月间行手术治疗的T2DM分为2组:肥胖组BMI≥28 kg/m^2)16例,超重组( BMI<28 kg/m^2)21例,均行GBP。观察术后3、6个月患者空腹血糖( FPG)、胰岛素抵抗指数( HOMA-IR)、胰岛素刺激释放( INS)、C肽释放、BMI、糖化血红蛋白(HbA1c)变化。结果术后3个月INS、C肽较术前均好转(P<0.05),术后6个月基本接近正常值;术后3个月HbA1c与术前比较明显下降(P<0.05),术后6个月基本接近正常值;HO-MA-IR与术前比较差异有统计学意义,同时肥胖组差异有统计学意义( P<0.05);术后3个月肥胖组体重较术前明显下降,术后6个月肥胖组体重下降达稳态,BMI<25 kg/m2达到15例(93.7%),差异有统计学意义(P<0.05),超重组体重有所下降,但差异无统计学意义(P>0.05)。肥胖组术后3、6个月血糖均不同程度下降,术后6个月肥胖组有效率92%,超重组有效率78%,2组总有效率90%。结论 GBP对不同BMI的T2DM均有明显治疗价值,但肥胖组显效优于超重组;GBP治疗T2DM疗效有效,值得临床推广。Objective To investigate the clinical effects of gastric bypass( GBP) on type 2 diabetes mel-litus(type 2 diabetes mellitus, T2DM)patients with different body mass index(BMI).Methods T2DM patients undergoing GBP from Sep.2012 to Jul.2013 were divided into 2 groups:obese group( BMI≥28 kg/m2 , 16 ca-ses)and overweight group(BMI〈28 kg/m2,21 cases).Changes of fasting plasma glucose(FPG), insulin resist-ance index(HOMA-IR)and insulin stimulation release(INS), C peptide release, BMI, glycosylated hemoglobin ( HbA1c) at 3 and 6 months after surgery were observed.Results INS and C peptide improved 3 months after surgery(P〈0.05),and they were close to normal at 6 months after surgery.HbA1c significantly decreased 3 months after surgery compared with that before surgery( P〈0.05) and it was close to normal at 6 months after sur-gery.Patients in obese group had significantly declined weight 3 months after surgery compared with that before surgery, and reached the steady state 6 months after surgery.15 cases(93.7%) in the obese group had BMI〈25 kg/m2 , and the difference had statistical significance ( P〈0.05 ) .Patients in the overweight group had their weight declined but no statistical difference was found(P〉0.05).Blood sugar in the obese group decreased with different degrees at 3 and 6 months after surgery.The effective rate was 92%for the obese group and 78%for the overweight group.The overall effective rate was 90%.Conclusion GBP has significant therapeutic value for T2DM patients with different BMI, especially for patients in obese group, which is worth of clinical promotion.

关 键 词:胃旁路术 2型糖尿病 体重指数 

分 类 号:R656.61[医药卫生—外科学]

 

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