代谢综合征与小肠黏膜损伤的相关性  

Metabolic syndrome is associated with more serious small intestinal mucosal injury

作　　者：钟豪杰[1] 吴礼浩[1] 陈羽[1] 陈美慧[1] 何兴祥[1] 

机构地区：[1]广东药学院附属第一医院消化内科,广东省广州市510080

出　　处：《世界华人消化杂志》2016年第11期1754-1759,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨代谢综合征(metabolic syndrome,MS)与小肠黏膜损伤的关系.方法:按入排标准回顾性收录自2011-08/2015-10于广东药学院附属第一医院住院行胶囊内镜检查者的临床资料.比较MS组与对照组(无MS任一组分)患者小肠黏膜不同病变的发生率、Lewis评分、小肠损伤严重程度,MS不同组分与小肠黏膜损伤的情况以及胰岛素抵抗与小肠黏膜损伤的相关性.结果:收录343例患者的临床资料,最终179例患者的资料可用于分析.其中诊断为MS者34例,对照组者145例.MS组小肠绒毛水肿发生率显著高于对照组(70.6%vs 33.1%,x^2=16.10,P<0.001),但两组溃疡发生率则无统计学差异(8.8%vs 4.8%,P=0.404).MS组Lewis评分也显著高于对照组(76.62分±81.55分vs 43.59分±86.96分,t=-2.016,P<0.001).高血糖患者Lewis评分比无高血糖患者高34.242分±17.263分,结果有统计学意义(t=1.984,P=0.048).此外,胰岛素抵抗指数越高,小肠Lewis评分越高(B=8.173,t=2.173,P=0.032).结论:MS可能为小肠黏膜损伤的危险因素,而高血糖则可能是MS引起小肠黏膜损伤最重要的组分.AIM： To investigate the relationship between metabolic syndrome and small intestinal mucosal injury.METHODS： Medical data of inpatients who underwent capsule endoscopy at Guangdong Pharmaceutical University from August 2011 to October 2015 were analyzed retrospectively.Different types of mucosal injuries, Lewis score and degree of severity were compared between patients with metabolic syndrome and those without. The effect of different components of metabolic syndrome on small intestinal mucosal injury and the relation between insulin resistance and Lewis score were assessed.RESULTS： Medical data of 179 patients could be used for analysis. Thirty-four patients with metabolic syndrome were included in a metabolic syndrome group, and 145 patients without metabolic syndrome were included in a control group. The prevalence of villous edema was significantly higher in the metabolic syndrome group（70.6% vs 33.1%, x^2 = 16.10, P 〈0.001）, but the incidence of ulcers showed no significant difference（8.8% vs 4.8%, P = 0.404）.In the metabolic syndrome group, Lewis score was also significantly higher（76.62 ± 81.55 vs43.59 ± 86.96, t =-2.016, P 〈0.001）. The Lewis score of patients with hyperglycemia was 34.242 ± 17.263, which was higher than that of patients without hyperglycemia（t = 1.984, P =0.048）. A higher homeostasis model assessment of insulin resistance value was associated with a higher Lewis score（B = 8.173, t = 2.173, P =0.032）.CONCLUSION： Metabolic syndrome may be a risk factor for small intestinal mucosal injury.Hyperglycemia may be the most effective component of metabolic syndrome for inducing small intestinal mucosal injury.

关 键 词：代谢综合征 小肠黏膜 胶囊内镜 

分 类 号：R589[医药卫生—内分泌] R574.5[医药卫生—内科学]