本文選題：型糖尿病 + 胃大部分切除術(shù)　； 參考：《廣東醫(yī)學(xué)》2016年20期

【摘要】：目的觀察胃大部分切除術(shù)后消化道重建對肥胖型2型糖尿病(T2DM)的療效,及其對機體網(wǎng)膜素-l(Omentin-1)、愛帕琳肽(Apelin)和內(nèi)臟脂肪素(Visfatin)水平的影響。方法選擇行胃大部分切除術(shù)的T2DM患者98例,根據(jù)胃大部分切除術(shù)消化道重建方式不同分為觀察組(56例)和對照組(42例),觀察組為roux-end-Y吻合術(shù),對照組為畢I式吻合。觀察兩組治療后對血糖控制的療效,及治療前后空腹血糖(FPG)、餐后2 h血糖(2h PBG)、糖化血紅蛋白(Hb A1C)、空腹胰島素(Fins)、餐后胰島素(2h Ins)、Omentin-1、Apelin和Visfatin水平的變化。結(jié)果觀察組的療效為85.71%,明顯優(yōu)于對照組的64.29%,差異有統(tǒng)計學(xué)意義(x2=5.762,P0.05)。兩組治療前的FPG、2h PBG、Hb A1C、FIns、2h Ins、HOMA-IR、HOMA-β、Omentin-1、Apelin和Visfatin水平差異無統(tǒng)計學(xué)意義(P0.05),治療后兩組的FPG、2Hpbg、Hb A1C、FIns、2h Ins、HOMA-IR、Apelin和Visfatin水平均較治療前明顯降低(P0.01),HOMA-β和Omentin-1水平較治療前明顯升高(P0.01),而觀察組的降低或者升高水平較對照組更為明顯(P0.01)。結(jié)論胃大部分切除行roux-end-Y消化道重建控制T2DM的療效優(yōu)于畢I式吻合,可提高機體胰島素的敏感性,緩解機體胰島素抵抗,可能與改善機體的脂肪因子紊亂有關(guān)。
[Abstract]:Objective to observe the effect of alimentary tract reconstruction after subtotal gastrectomy on obese type 2 diabetes mellitus (T2DM) and its effects on the levels of omentin-l (Omentin-1), epalineptide (Apelin) and visceral adipotin (visfatin) in obese type 2 diabetes mellitus (T2DM). Methods 98 patients with T2DM underwent subtotal gastrectomy were divided into observation group (n = 56) and control group (n = 42). The observation group was roux-end-Y anastomosis and the control group was Bii anastomosis. The changes of fasting blood glucose (FPG), postprandial blood glucose (2h PBG), glycosylated hemoglobin (HbA1C), fasting insulin (fins), postprandial insulin (2h ins), Omentin-1 apelin and Visfatin were observed before and after treatment. Results the curative effect of the observation group was 85.71, which was significantly better than that of the control group (64.29 vs 64.29, P 0.05). There was no significant difference in the levels of HBMA- 尾 Omentin-1Apelin and Visfatin between the two groups before and after treatment (P0.05). After treatment, the levels of FPGG 2HpbgHbA1CFFIns1InsHOMA-Apelin and Visfatin were significantly lower than those before treatment (P0.01), and the levels of Omentin-尾 and Omentin-1 were significantly higher than those before treatment (P0.01), while the levels of Omentin-1 and HOMA- 尾 in the observation group were significantly higher than those before treatment (P0.01). The level was significantly higher than that in the control group (P0.01). Conclusion the effect of roux-end-Y reconstruction of digestive tract in the control of T2DM is better than that of Bii anastomosis. It can improve the insulin sensitivity and alleviate the insulin resistance, which may be related to the improvement of the disorder of fat factor in the body.
【作者單位】： 同濟大學(xué)醫(yī)學(xué)院;上海市浦東新區(qū)周浦醫(yī)院普外科;
【分類號】：R587.1;R656.6
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本文編號：2060169