2型糖尿病患者上消化道症状与胃排空的超声检测

Upper gastrointestinal symptoms in type 2 diabetes mellitus and detection of gastric emptying by ultrasongraphy

目的:总结分析2型糖尿患者的上消化道症状,并检测其胃的液体排空功能.方法:2005-11/2007-10我院门诊和住院的2型糖尿病患者411例,统计上消化道症状的出现率及其严重程度评分,饮水后30、60、90min时,应用超声检测胃的排空率,与264例正常人的对照组进行比较分析.结果:411例患者中有上消化道症状者,高于对照组中相应症状的发生率(60.3%vs16.7%,P<0.01),症状中最常见的是餐后饱胀(77.9%)和腹胀嗳气(61.1%),症状严重度的评分也高于对照组(P<0.01);30、60、90min时,糖尿病患者胃的排空较对照组显著延缓(P<0.01).糖尿病患者中60min胃排空正常者与延缓者间只有早饱和恶心呕吐症状的发生率和严重程度评分有显著差异(P<0.05).结论:2型糖尿病患者上消化道症状有较高的发生率,其原因可能与胃排空延缓有关.超声法检测糖尿病患者的胃液排空功能简便易行,具有一定的临床应用价值.

AIM： To investigate the upper gastrointestinal relationship between （GI） symptoms and gastric emptying in patients with type 2 diabetes mellitus. METHODS： A total of 411 patients with type 2 diabetes mellitus were examined in Beijing Shunyi District Hospital from November 2005 to October 2007, and 264 normal individuals were used as controls. We statistically analyzed the rate of GI symptoms and the scores of severity. Ultrasound scan was performed to measure the gastric emptying rate 30, 60, 90 rain after drinking water. RESULTS： The rate of GI symtoms in diabetic patients was significantly higher than that in normal controls （60.3% vs 16.7%, P 〈 0.01）. The most common GI symptoms in diabetic patients were epigastric fullness （77.9%） and abdominal distention or belching （61.1%）. The scores of symptomic severity were also higher in diabetic patients （P 〈 0.01）. The gastric emptying in patients with diabetes was delayed as compared with that in normal controls 30, 60 and 90 min after drinking water （P 〈 0.01）. Diabetic patients with normal and delayed gastric emptying in 60 min showed significant differences only in early satiety, nausea and vomiting （P 〈 0.05）. CONCLUSION： Type 2 diabetic patients have a significantly higher prevalence of upper GI symptoms, and delayed gastric emptying may contribute to these symptoms. Ultrasound is convenient in detecting the gastric emptying of diabetic patients.