根除幽门螺旋杆菌对高龄2型糖尿病患者血糖的影响  

Effect of eradication of Helicobacter pylori on blood glucose in elderly patients with type 2 diabetes mellitus

作　　者：刘世雄[1] 赵丽 周芸[1] 王晶[1] 严祥[1] Liu Shixiong;Zhao Li;Zhou Yun;Wang Jing;Yan Xiang(Department of Geriatrics,First Hospital of Lanzhou University,Lanzhou,730000,China;Department of Medical Ultrasound,Affiliated Hospital of Gansu University of Traditional Chinese Medicine,Lanzhou 730020,China)

机构地区：[1]兰州大学第一医院老年科,730000 [2]甘肃中医药大学附属医院超声科,兰州730000

出　　处：《中华老年医学杂志》2020年第2期168-171,共4页Chinese Journal of Geriatrics

基　　金：兰州大学第一医院院内基金项目(ldyyyn2017-25)。

摘　　要：目的观察根除幽门螺旋杆菌(H.pylori)对高龄2型糖尿病患者血糖、胰岛素等的影响。方法前瞻性病例对照研究,80岁及以上高龄2型糖尿病H.pylori感染患者(糖尿病组)93例,同期无2型糖尿病的H.pylori感染高龄患者为对照组(89例),给予铋剂四联疗法根除H.pylori,比较治疗前及治疗后4、8、12和16周空腹血糖、胰岛素、糖化血红蛋白(HbA1c)、胃泌素以及胰岛素抵抗指数(HOMA-IR)、胰岛素分泌指数(HOMA-β)等,并评价H.pylori根除情况和记录不良反应。结果糖尿病组患者H.pylori根除率为73.1%(68例),对照组为84.3%(75例),两组比较差异无统计学意义。糖尿病组、对照组根除治疗前及治疗后4、8、12和16周空腹血糖、胰岛素、糖化血红蛋白、胃泌素和HOMA-IR、HOMA-β等,差异均无统计学意义;治疗期间糖尿病组患者便秘的发生率为25.8%(24例),对照组为12.4%(11例),差异有统计学意义(P<0.05)结论根除H.pylori对高龄2型糖尿病和非糖尿病H.pylori感染患者的空腹血糖、胰岛素、HbA1c等均无明显影响。Objective To examine the effect of helicobacter pylori(H.pylori)eradication on blood glucose and insulin levels in elderly patients with type 2 diabetes mellitus(T2DM).Methods This was a prospective case-control study.Ninety-three diabetic elderly patients(≥80 years)under glycemic control and with H.pylori infection were selected as the DM group and eighty-nine elderly patients(≥80 years)without T2DM and with H.pylori infection were selected as the control group.Among them,bismuth quadruple was given to eradicate H.pylori.Levels of fasting blood glucose,insulin,glycated hemoglobin(HbA1c),gastrin,insulin resistance index(HOMA-IR),and insulin secretion index(HOMA-β)were compared before treatment and at 4,8,12 and 16 weeks after treatment.Rates of H.pylori eradication and adverse reactions were evaluated.Results The eradication rate of H.pylori was similar between the DM group and the control group[73.1%(68 cases)vs.84.3%(75 cases),P>0.05].There were no significant differences in levels of fasting blood glucose,insulin,HbA1c,gastrin,HOMA-IR,and HOMA-βbefore treatment and at 4,8,12,16 weeks after treatment between the two groups(P>0.05).However,the incidence of constipation was significantly higher in the DM group than in the control group[25.8%(24 cases)vs.12.4%(11 cases),P<0.05].Conclusions The eradication of H.pylori has no significant effect on fasting blood glucose,insulin and HbA1c in elderly patients with or without T2DM.

关 键 词：糖尿病 2型 幽门螺杆菌 血糖 

分 类 号：R587.1[医药卫生—内分泌]