腹腔镜下Roux-en-Y胃转流术对不同体重2型糖尿病患者近期疗效的对比研究  

Short-term efficacy of laparoscopic Roux-en-Y gastric bypass for type 2 diabetes mellitus in different BMI patients

作　　者：冯雷[1] 郑韬[1] 张敬坡[1] 秦静[1] 

机构地区：[1]石家庄市第三医院普外二科,石家庄050017

出　　处：《山西医科大学学报》2016年第7期658-660,共3页Journal of Shanxi Medical University

摘　　要：目的探讨腹腔镜下Roux-en-Y胃转流术(L-RYGB)对不同体质量组2型糖尿病(T2DM)患者的近期疗效。方法取在我科行L-RYGB治疗的T2DM患者50例,按体质量指数(BMI)不同分为两组:正常体重组25例,BMI<25 kg/m^2;超重组25例,BMI>25 kg/m^2。所有患者分别在术前、术后1月、术后6月测量血浆空腹血糖(FPG)、餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c)和胰岛素抵抗指数(HOMA-IR)水平以及BMI水平,并进行比较。结果术前两组患者FPG、2h PG、Hb A1c和HOMA-IR水平比较无明显差异(P>0.05);术后1月,两组患者FPG、2h PG、Hb A1c和HOMA-IR水平较术前均明显下降(P<0.05),正常体重组血糖指标水平较超重组降低明显(P<0.05);两组BMI较术前无明显差异(P>0.05);术后6月,两组患者FPG、2HPG、Hb A1c、HOMA-IR均较术后1月降低(P<0.05),正常体重组血糖指标水平较超重组降低(P<0.05);两组BMI均较术前明显下降(P<0.05),正常体重组T2DM缓解率高于超重组(76%vs 64%,P<0.05)。结论 L-RYGB对治疗肥胖型与非肥胖型T2DM近期疗效显著,但术前BMI是影响术后缓解率的因素之一。Objective To explore the short-term therapeutic effect of laparoscopic Roux-en-Y gastric bypass（ L-RYGB） in treatment of type 2 diabetes mellitus（ T2DM） in different body mass index（ BMI） patients. Methods Fifty patients with T2DM undergoing L-RYGB were enrolled and divided into two groups： normal body mass group（ BMI 25kg/m^2） and overweight group（ BMI 25 kg/m^2）. The levels of fasting plasma glucose（ FPG）,2 h postprandial plasma glucose（ 2h PG）,hemoglobin A1c（ Hb A1c）,homeostasis model assessment-insulin resistance index（ HOMA-IR） and BMI in all patients were measured before operation,at 1,6 month after operation. Results Before operation,the levels of FPG,2h PG,Hb A1 c and HOMA-IR showed no difference between two groups（ P〈0. 05）. At 1 month after operation,the levels of FPG,2h PG,Hb A1 c and HOMA-IR in two groups were significantly decreased compared with the levels before operation（ P〈0.05）,but the level of BMI in two groups showed no significant change（ P〈0.05）. The levels of FPG,2h PG,Hb A1 c and HOMA-IR in two groups were significantly lower at 6 month after operation than those at 1 month（ P〈0.05）,and the level of BMI in two groups was lower than that before operation（ P〈0. 05）. The remission rate was lower in overweight group than in normal body mass group（64%vs76%,P〈0.05）. Conclusion The short-term effect of L-RYGB is obvious for T2 DM patients who subjects obesity or not,but the level of BMI before operation is one of the factors that influence the remission rate of L-RYGB for T2DM.

关 键 词：胃转流术 2型糖尿病 体质量指数 

分 类 号：R587.1[医药卫生—内分泌]