正常人和糖尿病病人消化间期移行性复合运动的研究

The Study of Migrating Motor Complexinthe Healthy and TypeⅡDiabetes

为探讨正常人和糖尿病患者消化间期移行性复合运动（ ＭＭＣ） 的规律，应用胃十二指肠测压技术对１６ 例健康志愿者和５１ 例Ⅱ型糖尿病患者进行ＭＭＣ 检测。结果显示正常对照组ＭＭＣ 完整出现者占７５ ．０ ％ （１２／１６） ；糖尿病组ＭＭＣ 正常者仅２７ ．５ ％ （１４／５１） ，明显低于对照组（ Ｐ＜ ０ ．０１） ，其中ＭＭＣ Ⅲ期缺失者占４１ ．１ ％ ，ＭＭＣ Ⅲ期胃窦收缩波幅较对照组明显减低（ Ｐ＜ ０ ．０５） 。提示：胃十二指肠测压为糖尿病胃肠运动功能障碍的早期诊断和疗效观察的有效手段。

In order to investigate characteristic of migrating motor complex ( MMC) in health and diabetic patients ,51 type Ⅱdiabetes patients ( NIDDM) and 16 healthy volunteers were studied after an overnight fast by means of 6 channel computerized manometry of antroduodenal region for at least 240 min . The results showed that phase Ⅲofthe MMCoriginated in the antru m in 14/51(27 .5 % ) of the diabetic patients , which was significantly less than thatin 12/16(75 .0 % ) of the healthys( P< 0 .01) . Phase Ⅲwas absentin 21/51(41 .1 % ) ofthe patients and in 2/16(12 .5 % ) ofthe controls ( P< 0 .05) . The amplitude of phase Ⅲin antru m was lower in the diabetic group than that in the control 〔(8 .1 ± 3 .5) kPa vs (10 .5 ±3 .1) kPa , P< 0 .05〕. Period of phase Ⅱwas also longer in the diabetes patients than normal subjects 〔(27 .9 ±13 .1) min vs (19 .9 ±6 .1) min ,P< 0 .01〕.Phase Ⅱand phase Ⅲwere all absent in 6/51(11 .8 % ) of the diabetic patients during 240 min , but it was not obseved in the controls. The results of this study demonstrated that about 70 % NIDDM patients had abnormal MMC even before the clinicalsym ptoms of gastroparesis occured ,and the gastrodudenal manometry might be an useful method in the early diagnosis of diabetic gastrointestinal dismotility .