2型糖尿病患者胶囊内镜下小肠绒毛形态学观察  

Morphology observation on villi of small intestine of patients with type 2 diabetes mellitus by capsule endoscopy

作　　者：杨元生[1,2] 容海鹰[1,2] 张文瑜[1,2] 周文[3] 陈垦[4] 王晖[3] 

机构地区：[1]广东药学院附属第二医院 [2]广州新海医院消化内科,广东广州510300 [3]广东药学院中药学院药理学教研室,广东广州510006 [4]广东药学院临床医学院内科学教研室,广东广州510310

出　　处：《中国内镜杂志》2015年第8期798-801,共4页China Journal of Endoscopy

基　　金：广州市科技计划项目(No:201300000157);新海医院科技项目(No:201306)

摘　　要：目的观察2型糖尿病患者的小肠绒毛形态变化对其血糖的影响。方法收集2型糖尿病患者12例(观察组),非糖尿病患者12例(对照组)和健康体检者8例(正常组),入组患者均接受胶囊内镜检查,记录比较两组患者的胃通过时间(GTT)、小肠通过时间(SBTT)、全小肠完成率(CR)、Lewis评分、阳性病变率、临床症状、C反应蛋白(CRP)、随机血糖(RBS)和糖化血红蛋白(Hb A1c)变化情况。结果与对照组和正常组相比,观察组患者的GTT和SBTT延长,小肠绒毛评分和阳性病变率、CRP、RBS和Hb A1c水平以及腹泻和便秘发生率均较高;统计显示2型糖尿病患者的SBTT与便秘和Lewis评分均正相关,Lewis评分与Hb A1c呈正相关。结论 2型糖尿病患者存在不同程度的小肠绒毛病变及功能紊乱,推测长期血糖控制不佳是重要原因。[ Objective ] To observe the effect of morphologic change of villi of small intestine on blood glucose of patients with type 2 diabetes mellitus （T2DM）. [ Methods ] Twelve T2DM patients were collected in observation group, another twelve non-DM patients were in control group and eight health people in normal group. All the patients underwent capsule endoscopy （CE）, gastric transit time （GTT）, small bowel transit time （SBTF）, entire small intestine completion rate （CR）, lewis scores, the rates of positive lesions, clinical symptoms, C reactive protein （CRP）, random blood sugar （RBS） and hemoglobin Alc （HbAlc） of patients in two groups were recorded and compared. [ Results ] In compared with control group and normal group, the GTT and SBTF were prolonged, the scores of intestinal villus, serum CRP level, the rates of positive lesions, the levels of RBS and HbAlc, and the incidences of diarrhea and constipation were higher of patients in observation group. The statistics showed that T2DM patients SBTT had positive relationship with constipation and lewis scores, and lewis scores had a positive correlation with glycosylated hemoglobin. [ Conclusion ] Different degrees of intestinal functional disorder and villus damage have happened in patients with T2DM, we suppose that the bad blood glucose control in long-term is an important reason.

关 键 词：2型糖尿病 胶囊内镜 小肠绒毛 糖化血红蛋白 随机血糖 

分 类 号：R574.5[医药卫生—消化系统] R587.1[医药卫生—内科学]