LSG和LRYGB治疗肥胖型2型糖尿病的疗效对比研究  

Comparison research on curative effect of LSG and LRYGB in treating obese type 2 diabetes mellitus

作　　者：王焱[1] 姜涛[1] 马晶[2] 于洋[1] Wang Yan Jiang Tao Ma Jing Yu Yang(Department of Bariatric and Metabolic Surgery, China-Japan Friendship Hospital affiliated to Jilin Univerity, Changchun 130012, China Department of Operating theatre, Tumor Hospital of Jilin Province, Changchun 130021, China)

机构地区：[1]吉林大学中日联谊医院减重代谢外科,长春130000 [2]吉林省肿瘤医院手术室,长春130012

出　　处：《中华肥胖与代谢病电子杂志》2016年第3期146-149,共4页Chinese Journal Of Obesity and Metabolic Diseases：Electronic Edition

摘　　要：目的对比腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)和腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)治疗肥胖型2型糖尿病的疗效。方法回顾性分析2014年7月至2016年2月在吉林大学中日联谊医院代谢外科接受代谢手术治疗的52例肥胖合并2型糖尿病患者的临床资料。所有患者均签署知情同意书,符合医学伦理学规定。根据手术方式的不同将患者分为LSG组和LRYGB组。其中LSG组29例,男8例,女21例;年龄(38±14)岁。LRYGB组23例,男11例,女12例;年龄(44±12)岁。比较两组患者术前和术后3、6个月的体重、体质指数(body mass index,BMI)、空腹血糖(fasting plasma glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin A1c,Hb A1c)、餐后2小时血糖(2-hour postprandial blood glucose,2h PG)、甘油三酯和总胆固醇水平等。两组患者临床资料的比较采用t检验和χ~2检验。结果术后6个月,LSG组患者的FPG、2h PG、Hb A1c、BMI、甘油三酯和总胆固醇水平分别为(5.5±0.8)mmol/L、(7.9±0.6)mmol/L、(6.1±0.8)%、(30±7)kg/m^2、(1.0±0.5)mmol/L和(4.0±0.7)mmol/L,与LRYGB组的(5.9±1.1)mmol/L、(7.8±0.7)mmol/L、(5.7±0.7)%、(31±12)kg/m2、(1.1±0.6)mmol/L和(3.8±0.6)mmol/L差异无统计学意义(t=1.13、1.15、1.75、0.28、0.53、1.81,P>0.05)。结论 LSG和LRYGB均能在短期内有效减轻患者的体重和改善患者的糖尿病状态,两者的疗效差异还有待于延长随访时间、增加样本例数来进一步明确。ObjectiveTo compare the clinical effect of laparoscopic sleeve gastrectomy （LSG） and laparoscopic Roux-en-Y gastric bypass （LRYGB） in treating obese type 2 diabetes mellitus. Methods Clinical data of 52 patients with obese type 2 diabetes mellitus undergoing metabolic surgery in China-Japan Friendship Hospital affiliated to Jilin Univerity between July 2014 and February 2016 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the LSG group and LRYGB group according to different surgical approaches. Among the 29 patients of LSG group, 8 were males and 21 were females with an average age of （38±14） years old. Among the 23 patients of LRYGB groups, 11 were males and 12 were females with an average age of （44±12） years old. Levels of weight, body mass index （BMI）, fasting plasma glucose （FPG）, glycosylated hemoglobin A1c （HbA1c）, 2-hour postprandial blood glucose （2hPG）, triglyceride and total cholesterol before and 3, 6 months after surgery were compared between the two groups. Clinical data of the two groups were compared usingt test andχ2 test.Results At 6 months after surgery, FPG, 2hPG, HbA1c, BMI, triglyceride and total cholesterol level of the LSG group patients were （5.5±0.8） mmol/L, （7.9±0.6） mmol/L, （6.1±0.8）%, （30±7） kg/m2、（1.0±0.5） mmol/L and （4.0±0.7） mmol/L respectively,which had no statistical difference with （5.9±1.1） mmol/L, （7.8±0.7） mmol/L, （5.7±0.7）%, （31±12） kg/m2, （1.1±0.6） mmol/L and （3.8±0.6） mmol/L of the LRYGB group （t=1.13, 1.15, 1.75, 0.28, 0.53, 1.81,P〉0.05）.Conclusions LSG and LRYGB can both reduce weight and improve diabetes effectively in a short time, but the difference between their curative effect remains to be defined by extending follow-up time and increasing sample sizes.

关 键 词：糖尿病 2型 肥胖症 腹腔镜Roux-en-Y胃旁路术 腹腔镜袖状胃切除术 

分 类 号：R589.2[医药卫生—内分泌] R587.1[医药卫生—内科学] R656.6[医药卫生—临床医学]