小肠电刺激对正常人血糖水平的影响及其可能的机制

Effect of intestinal electrical stimulation on postprandial blood glucose in healthy volunteers and its possible mechanism

目的研究小肠电刺激对健康成年人餐后血糖的影响及其可能的机制，探讨小肠电刺激对糖尿病可能的治疗作用。方法健康正常人6例，经鼻将带有刺激电极的鼻胃管植入十二指肠，给予150克葡萄糖水口服，并监测餐前及餐后2小时内静脉血糖及血清胰岛素水平，同时用B超监测胃排卒，每人均接受真性和假性小肠电刺激实验两次，同时记录餐后消化小良症状。结果小肠电刺激町显著降低餐后血糖水平及血清胰岛素水牛。给予真性小肠电刺激后，餐后90分钟内各时间点血糖水平显著低于假性电刺激时的血糖水平，血清胰岛素水平在服用糖水60分钟后明显低丁假性刺激组（P〈0．05）；小肠电刺激抑制胃排空，给予真性小肠电刺激时胃半排空时间为（40．67±5．72）分钟，显著高于假性小肠电刺激时的胃半排空时问[（27．33±4．03）分钟]，P〈0．05；给P真性小肠电刺激时受试者消化不良症状总积分为（18．83±9．15）分，显著高于假性小肠电刺激时消化不良症状总积分[（6．83±4．92）分，P〈0．05。结论小肠电刺激叮降低健康正常人餐后血糖水平，可能是1种治疗糖尿病的新方法，其机制叮能与抑制胃排空等因素有关。

Objective To investigate the effect of intestinal electrical stimulation（IES） on postprandial blood glucose in healthy volunteers and its possible mechanism. Methods Six healthy volunteers were enrolled in a 2-session study（ real and sham sessions）. All volunteers were incubated with a nasal du- odenal feeding tube with 2 ring electrodes into the duodenum and took glucose meal. The postprandial blood glucose and serum insulin at different time point 2 hours after the meal, gastric emptying half time （T1/2） were measured with real or sham IES and dyspepsia symptoms were scored. Results 1 ） The post- prandial blood glucose at different time point 90rain after the meal and the serum insulin at 60min ,90 rain and 120 rain after the meal in real IES session were significantly lower than those in the sham session;2） The T1/2 of gastric emptying was 40.67±5.72 rain in the real session, which was significantly higher than that in the sham session（ 27.33 ± 4.03 rain, P 〈 0.05 ） ;3 ）The dyspeptic symptoms score in real session was significantly higher than that in sham session （ P 〈 0.05）. Conclusion IES can decrease the postprandial glucose level, which may contribute to its effect on delaying gastric emptying and other unknown mechanisms.