本文選題：糖尿病　切入點(diǎn)：糖尿病周圍神經(jīng)病變　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：背景:目前針對糖尿病胃動力障礙(Diabetic gastromotility disorder,DGMD)的早期診斷手段匱乏,既往對胃腸激素與DGMD的研究眾多,而糖尿病周圍神經(jīng)病變(Diabetic peripheral neuropathy,DPN)與DGMD之間關(guān)系的研究較少,且針對DPN的病變程度與DGMD之間關(guān)系的研究文章則鮮見。目的:通過檢測胃腸電圖等,了解不同程度DPN患者發(fā)生胃腸動力障礙的風(fēng)險(xiǎn)。方法:符合研究標(biāo)準(zhǔn)的2型糖尿病患者75例,其中男43例,女32例,男女比例1:0.7,年齡31~75歲,平均(55.6±10.7)歲,根據(jù)患者的DPN的臨床癥狀及肌電圖結(jié)果,將患者分為無病變組,輕度病變組及中重度病變組三組,所有患者均行6分鐘的餐前及餐后胃電圖檢查,同時(shí)詳細(xì)評估患者的DPN癥狀及消化道癥狀,行肌電圖檢查,檢測空腹、餐后血糖、糖化血紅蛋白及甘油三脂等生化指標(biāo),最后比較三組患者的胃電參數(shù)及生化指標(biāo)。結(jié)果:(1)三組患者的臨床資料:性別、年齡、BMI比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),三組患者的糖尿病病程差異有統(tǒng)計(jì)學(xué)意義,再經(jīng)LSD檢驗(yàn)除輕度病變組與中度病變組無差異外,其他倆組間比較都有差異,即無病變組患者的平均病程與輕中度病變組均存在差異性(P1=0.002,P2=0.013),無病變組患者的平均病程分別小于輕中度病變組(無病變組與輕中度病變組的均值差分別為-5.59、-4.19);三組患者的相關(guān)生化指標(biāo):空腹血糖、糖化血紅蛋白、血脂均呈升高趨勢,但差異無統(tǒng)計(jì)學(xué)意義(P0.05)。(2)三組患者的餐前波幅及餐前反應(yīng)面積按神經(jīng)病變輕重程度依次呈下降趨勢,但差異無統(tǒng)計(jì)學(xué)意義(P0.05);三組患者的餐后波幅、餐后反應(yīng)面積、餐后與餐前功率比均依次呈下降趨勢,三組間的差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)從糖尿病患者的胃電參數(shù)變化的臨床資料的相關(guān)性(表3)分析,BMI與餐前波幅、餐前反應(yīng)面積呈負(fù)相關(guān)(r=-0.260、P=0.024;r=-0.265、P=0.022),BMI與餐后波幅、餐后反應(yīng)面積不相關(guān);年齡、病程分別與F值呈負(fù)相關(guān)(r=-0.236、P=0.041;r=-0.358、P=0.002),FBG、HBA1C、BMI與F值呈正相關(guān)(r=0.306、P=0.008;r=0.230、P=0.048;r=0,300、P=0.009),年齡、病程、FBG、HBA1C與胃電參數(shù)餐前波幅、餐后波幅、餐前RA及餐后RA均不相關(guān)。結(jié)論:糖尿病周圍神經(jīng)病變的患者早期即可出現(xiàn)胃電圖異常,而隨著周圍神經(jīng)病變程度加重,患者胃電圖異常更為明顯。
[Abstract]:Background: at present, there is a lack of early diagnostic methods for diabetic gastromotility disorder.There have been many studies on gastrointestinal hormones and DGMD in the past, but there are few studies on the relationship between diabetic peripheral neuropathyDPNs and DGMD in diabetic peripheral neuropathy. There are few articles on the relationship between the pathological degree of DPN and DGMD. Methods: 75 patients with type 2 diabetes mellitus, including 43 males and 32 females, were enrolled in this study. The ratio of male to female was 1: 0.7, with an average age of 55.6 鹵10.7 years. According to the clinical symptoms and the results of electromyography of DPN, the patients were divided into three groups: no lesion group, mild lesion group and moderate and severe lesion group. All the patients were examined by 6 minutes of preprandial and postprandial electrogastrogram. At the same time, the symptoms of DPN and digestive tract were evaluated in detail, electromyography was performed, fasting, postprandial blood glucose, glycosylated hemoglobin and triglyceride were detected. Results the clinical data of the three groups were as follows: sex, age and BMI had no significant difference (P 0.05). The course of diabetes in the three groups was significantly different. After LSD test, there was no difference between mild and moderate lesion groups, but there were differences between the other two groups. That is to say, there was difference between the mean course of disease in the non-pathological group and that in the mild to moderate lesion group. The mean course of disease in the non-pathological group was lower than that in the mild to moderate lesion group (-5.59 鹵4.19), and the difference among the three groups was also higher than that in the non-pathological group and the mild to moderate lesion group, and the difference between the non-pathological group and the mild to moderate lesion group was -5.59% -4.19%. Related biochemical measures: fasting blood glucose, Glycosylated hemoglobin and serum lipids showed an increasing trend, but there was no significant difference between the three groups. The amplitude of preprandial wave and the area of preprandial reaction showed a decreasing trend according to the severity of neuropathy. But the difference was not statistically significant (P 0.05), the amplitude of postprandial wave, the area of postprandial reaction and the power ratio of postprandial to preprandial were all decreased in turn. There were significant differences among the three groups (P 0.05). The correlation between BMI and the amplitude of preprandial response was analyzed from the clinical data of gastric electrical parameters in diabetic patients (Table 3). The area of preprandial reaction was negatively correlated with the amplitude of postprandial response (P 0.024) and postprandial response area (P0.024) and postprandial response area (P0.02. 022), age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, age, and age. There was a negative correlation between the course of disease and F value (r = -0.236p = 0.041n ~ (-1) ~ 0.358p ~ (0.002)) and the BMI of HBA _ (1C) of FBGn / HBA _ (1) / F were positively correlated with F value (r = 0.306p ~ (0.008) P ~ (0.230) P ~ (0.048) P ~ (0) 300 P ~ (0.009)), age, age, course of disease, FBGG ~ (HBA1C) and the amplitude of gastric electrical parameters before and after meal, the amplitude of postprandial wave, the amplitude of postprandial wave, Conclusion: abnormal electrogastrogram can be found in patients with diabetic peripheral neuropathy at the early stage, but with the severity of peripheral neuropathy, the abnormal electrogastrogram is more obvious in patients with diabetic peripheral neuropathy than in patients with preprandial or postprandial RA.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R587.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 何煦;丘霞;周春來;;不同體重指數(shù)對初發(fā)2型糖尿病并發(fā)癥及治療方案的影響[J];中國醫(yī)藥導(dǎo)報(bào);2014年27期

2 徐丹丹;馬躍華;袁慧娟;張晶;趙志剛;;糖尿病周圍神經(jīng)病變篩查方法的實(shí)用研究[J];中國糖尿病雜志;2014年05期

3 徐湘;許嵐;;糖尿病周圍神經(jīng)痛發(fā)病機(jī)制的研究進(jìn)展[J];中華臨床醫(yī)師雜志(電子版);2011年24期

4 葉盛開;安伶;王雁;蒲雯雯;;糖尿病胃輕癱致空腹血糖明顯升高34例分析[J];臨床軍醫(yī)雜志;2011年06期

5 龐國明;閆鏞;鄭曉東;;糖尿病周圍神經(jīng)病變中醫(yī)防治指南[J];中國中醫(yī)藥現(xiàn)代遠(yuǎn)程教育;2011年22期

6 郟伊范;宋志偉;;糖尿病慢性并發(fā)癥與血清同型半胱氨酸和超敏C反應(yīng)蛋白的關(guān)系[J];檢驗(yàn)醫(yī)學(xué)與臨床;2010年22期

7 吳波;鄭長青;;幽門螺桿菌、胃腸激素與糖尿病胃輕癱的關(guān)系[J];世界華人消化雜志;2010年15期

8 吳波;杜強(qiáng);鄭長青;李倩;;胃泌素和生長抑素在糖尿病胃輕癱中作用的研究[J];中國醫(yī)科大學(xué)學(xué)報(bào);2009年10期

9 趙宏賢;陳霞;楊燕;郭勇;李昌平;余鴻;;糖尿病胃輕癱大鼠胃平滑肌細(xì)胞超微結(jié)構(gòu)變化[J];現(xiàn)代預(yù)防醫(yī)學(xué);2008年09期

10 藍(lán)宇;吳改玲;閆冰;王杞;張靈云;張?jiān)孪?;糖尿病消化不良患者的自主神經(jīng)功能及其對近端胃功能的影響[J];胃腸病學(xué);2006年08期

，

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