糖尿病患儿胃电参数研究

Electrogastrographic study on children with diabetes mellitus

目的探讨糖尿病(diabetes mellitus,DM)患儿胃电参数的变化规律。方法选择诊断明确的1型糖尿病患儿50例为试验组,25例健康儿童为对照组。采用EGEG-5D2型胃肠电图微机处理系统,对两组患儿进行餐前、餐后各15min的胃电图描记及数据分析,并对胃电参数的进餐前后做对照分析,参数包括胃电平均频率、平均波幅等。试餐经我院营养师测算,总热量分别为836.80KJ(200kcal)和1255.20KJ(300kcal)两套。所得数据采用正态性t检验。结果对照组胃电参数变化主要表现在波幅上,1导餐前为(130.01±47.20)μV,餐后为(268.72±109.53)μV;2导餐前为(147.45±65.67)μV,餐后为(201.48±79.03)μV,1导和2导餐后均明显高于餐前(P=0.001和P=0.002);而DM组血糖控制不满意组、长病史组餐后波幅不升高,提示可能存在餐后胃动力紊乱;DM组患儿不论是否存在腹部症状,其波幅均表现为餐后高于餐前;对照组中2导餐后频率均值较餐前升高;而DM组两导联餐后频率均低于对照组,尤以胃体部为主;血糖控制不满意组餐后频率较餐前减慢;有腹部症状的患儿餐后频率变化不明显。结论部分DM患儿存在胃节律紊乱。

Objective To explore the electro-gastro-graphic changes on children with DM. Methods Electrogastrography （EGEG-5D2 system） was undertaken in 50 DM cases （23 boys, 27 girls） and 25 cases （13 boys, 12 girls）. The age of patients in DM group was from 7 to 18 years old. The course of DM before electro-gastric test was 20 days to 7 years. 17（34.0%） had digestive symptoms. The age, height, weight and BMI of patients in the control group were all in normal range. 15 min test was continued before and after meal. Meal＇s effect on electro-gastric activity was analyzed based on the changes of gastric frequency and amplitude of gastric electric activity＇s waves which recorded with EGG after food. Results The waves＇ mean value of width after meals in the two groups who had long DM history or whose blood glucose was under controlled were the same as in normal group. The waves＇ mean value after meals in DM group was higher than that of before meal which had no difference whether patients had digestive symptoms or not. In contrast to high mean frequency in normal group after meal, it was slower than that before meal, especially at the position of sinus ventriculi. The mean frequency after meals in patients who had digestive symptoms and pationts whose blood glucose had been under controlled had shown no faster but even slower. Conclusions Some children with DM have abnormal electro-gastric changes.