2型糖尿病合并腹泻的临床特征及相关因素分析

Clinical feature and correlation factors in type 2diabetes patients with diarrhea

[目的]研究2型糖尿病(DM)合并腹泻患者肠道菌群及胃肠动力变化,探讨2型DM腹泻的发病机制。[方法]通过大便特检、消化道钡餐及纤维结肠镜检查研究60例2型DM合并腹泻患者的肠道菌群、胃肠动力及肠黏膜变化,并与40例无腹泻的2型DM患者对照。[结果]与对照组比较,2型DM腹泻患者血糖水平更高(P<0.01),无明显肠道菌群失调,但有脂肪吸收不良(P<0.01),且胃肠动力明显紊乱。[结论]2型DM腹泻患者存在胃肠动力紊乱,可能与高血糖、糖尿病植物神经病变有关。

[Objective]To investigate intestinal microflora and gastrointestinal motility in patients with type 2 diabetes mellitus （DM） and diarrhea so as to explore the mechanisms of diarrhea in diabetes. [Meth- ods]Fecal specific test,gastrointestinal barium meal and colonofiberscope were used to assess the intestinal microflora and gastrointestinal motility in type 2 DM patients with diarrhea. 40 age and sex matched type 2 DM patients without diarrhea served as controls. [Results]The associated disorders in DM patients include higher blood glucose and fat malabsorption （P^0.01 for both）. Although intestinal microflora were simi- lar in both groups,the gastrointestinal motility was disordered significantly in DM patients with diarrhea. [Conclusion] Gastrointestinal motility was abnormal in type 2 DM patients with diarrhea. Several mecha- nisms such as hyperglycemia and autonomic neuropathy may result diabetic diarrhea.