腹腔镜袖状胃切除联合胃底折叠术后血浆胃饥饿素水平变化及减重效果的影响因素分析  

Changes in plasma ghrelin and influencing factors of weight loss effects after sleeve gastrec-tomy combined with fundoplication surgery

作　　者：黎鑫 艾克拜尔·艾力[2] 阿丽叶古丽·艾皮热[1] 皮尔地瓦斯·麦麦提玉素甫[1] 麦麦提艾力·麦麦提明 玉素江·图荪托合提 黄旭东 克力木·阿不都热依木 Lixin;Aikebaier Aili;Aliyeguli Aipire;Pierdiwasi Maimaitiyusufu;Maimaitiaili Maimaitiming;Yusujiang Tusuntuoheti;Huang Xudong;Kelimu Abudureyimut(Department of Minimally Invasive Surgery,Hernia and Abdominal Wall Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,China;Research Institute of General and Minimally Invasive Surgery,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830011,China;Graduate School of Xinjiang Medical University,Urumqi 830054,China;Xinjiang Clinical Research Center for Gastroesophageal Reflux Disease and Bariatric Metabolic Surgery,Urumqi 830011,China)

机构地区：[1]新疆维吾尔自治区人民医院微创、疝与腹壁外科,乌鲁木齐830011 [2]新疆维吾尔自治区人民医院普外微创研究所,乌鲁木齐830011 [3]新疆医科大学研究生院,乌鲁木齐830054 [4]新疆维吾尔自治区胃食管反流病及减重代谢外科临床研究中心,乌鲁木齐830011

出　　处：《中华消化外科杂志》2024年第8期1065-1072,共8页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(82060166);新疆维吾尔自治区人民医院院内项目(20230131);新疆维吾尔自治区研究生创新项目(XJ2023G201)。

摘　　要：目的探讨腹腔镜袖状胃切除联合胃底折叠术(LSGFD)后血浆胃饥饿素水平变化及减重效果的影响因素。方法采用回顾性队列研究方法。收集2023年4-6月新疆维吾尔自治区人民医院收治的115例肥胖症患者临床资料;男37例, 女78例;年龄为(37±9)岁。115例患者中, 93例行腹腔镜袖状胃切除术(LSG), 设为LSG组;22例行LSGFD, 设为LSGFD组。正态分布的计量资料以x±s表示, 组间比较采用独立样本t检验。计数资料以绝对数表示, 组间比较采用χ^(2)检验。重复测量数据采用重复测量方差分析, 并用球形检验其方差。采用Logistic回归模型进行单因素和多因素分析。结果 (1)两组患者手术前后胃饥饿素水平变化情况。LSG组和LSGFD组患者术前至术后6个月胃饥饿素水平分别由(16±14)×10^(2) ng/L变化至(10±4)×10^(2) ng/L和(12±11)×10^(2) ng/L变化至(11±3)×10^(2) ng/L, 两组术前至术后6个月胃饥饿素水平变化趋势时间效应、组间效应、交互效应比较, 差异均无统计学意义(F_(时间)=2.199, F_(组间)=0.001, F_(交互)=0.793, P>0.05)。LSG组患者术后6个月与术前胃饥饿素比较, 差异有统计学意义(t=4.148, P<0.05);LSGFD组患者术后6个月与术前胃饥饿素比较, 差异无统计学意义(t=0.622, P>0.05)。(2)两组患者手术前后减重及代谢相关指标变化情况。①LSG组和LSGFD组患者术前至术后6个月体质量变化趋势时间效应比较, 差异有统计学意义(F_(时间)=242.285, P<0.05), 组间效应、交互效应比较, 差异均无统计学意义(F_(组间)=1.163, F_(交互)=0.606, P>0.05)。LSG组和LSGFD组患者术后6个月与术前体质量比较, 差异均有统计学意义(t=23.597, 14.680, P<0.05)。②LSG组和LSGFD组患者术前至术后6个月体质量指数变化趋势时间效应比较, 差异有统计学意义(F_(时间)=382.431, P<0.05), 组间效应、交互效应比较, 差异均无统计学意义(F_(组间)=1.619, F_(交互)=1.085, P>0.05)。LSG组�Objective To investigate the changes in plasma ghrelin and influencing factors of weight loss effects after laparoscopic sleeve gastrectomy combined with fundoplication surgery(LSGFD).Methods The retrospective cohort study was conducted.The clinical data of 115 obesity patients who were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from April to June 2023 were collected.There were 37 males and 78 females,aged(37±9)years.Of 115 pati-ents,93 cases undergoing laparoscopic sleeve gastrectomy(LSG)were divided into the LSG group,and 22 cases undergoing LSGFD were divided into the LSGFD group.Measurement data with normal distribution were represented as Mean+sD,and the independent sample t test was used for com-parison between groups.Count data were described as absolute numbers,and the chi-square test was used for comparison between groups.Repeated measurement data were analyzed using the repeated ANOVA,and their variances were tested using a spherical test.The Logistic regression model was used for univariate and multivariate analyses.Results(1)Changes in preoperative and postoperative plasma ghrelin in two groups of patients.The plasma ghrelin of patients at preopera-tive and postoperative 6 months changed from(16±14)×10°ng/L to(10±4)×10^(2)ng/L in the LSG group and changed from(12±11)×10^(2)ng/L to(11±3)×10^(2)’ng/L in the LSGFD group.There was no significant difference in the time effect,inter group effect,and interaction effect of changes in plasma ghrelin between the LSG group and the LSGFD group before and after surgery at 6 months(F_(time)=-2.199,F_(group)=0.001,F_(interuaction)=0.793,P>0.05).There was a significant difference in plasma ghrelin in the tera LSG group before and after surgery at 6 months(t=4.148,P<0.05),and there was no significant difference in plasma ghrelin in the LSGFD group before and after surgery at 6 months(t=0.622,P>0.05).(2)Changes in preoperative and postoperative weight loss and metabolic related indicators in two groups of patients.O There was a si

关 键 词：肥胖症 减重代谢外科 袖状胃切除 胃底折叠 胃饥饿素 减重效果 

分 类 号：R656.61[医药卫生—外科学]