胃肠道激素介导T2DM胃旁路手术胰岛素抵抗的研究

Analyzing of Gastrointestinal Hormone-Aediated Insulin Resistance in T2DM Gastric Bypass Surgery

目的:探讨分析胃旁路手术对T2DM胃肠道激素、胰岛素抵抗的影响;方法:选取20例行胃旁路手术的2型糖尿病患者,观察临床疗效,比较患者术前和术后的临床相关指标,胰岛素抵抗,胃肠道激素等;结果:治愈8例(40.00%),控制6例(30.00%),改善6例(30.00%),无效0例,患者体重、腰围、Hb Al C、C肽、HOMA-IR、FPG术后6个月较术前均显著下降,差异具有统计学意义(P<0.05),而BMI、TC、TG、LDL-C、HDL-C、ALT及FINS与术前差异无统计学意义(P>0.05),患者术后6个月激素Ghrelin、LEP、CCK较术前显著上升,而GLP-1、GIP较术前显著减低,差异均具有统计学意义(P<0.05),ADP术前、术后差异无统计学意义(P>0.05);结论:胃旁路手术能够改善2型糖尿病患者胃肠道激素水平,促进平衡,减少胰岛素抵抗,保护β细胞功能,减少糖尿病并发症的发生,延缓糖尿病的进展,值得进一步在临床上推广。

Objective：To discuss affects of gastric bypass surgery for T2 DM gastrointestinal hormones,insulin resistance.Methods：To select 20 cases of gastric bypass surgery in patients with type 2 diabetes.To Observed clinical efficacy.Comparing clinically relevant indicators of insulin resistance,gastrointestinal hormone of patients before surgery and postoperative.Results：8 patients were cured（40.00%）,the control 6 cases（30.00%）,improved in 6 cases（30.00%）,0 cases,patient body weight,waist circumference,Hb Al C,C peptide,HOMA-IR,FPG compared with that after 6 months former decreased significantly,the difference was statistically significant（P〈0.05）,while the former BMI,TC,TG,LDL-C,HDL-C,ALT and FINS and surgery was no significant difference（P0.05）,preoperative after six months of hormone Ghrelin,LEP,CCK increased significantly compared with preoperative,and GLP-1,GIP was significantly lower than the preoperative,the differences were statistically significant（P〈0.05）,ADP before surgery,the difference was not statistically significance（P〈0.05）;Conclusion：Gastric bypass surgery can improve type 2 diabetes patients with gastrointestinal hormone levels,and promote balance,reduce insulin resistance,protection of β-cell function,reduce the incidence of complications of diabetes,delaying the progression of diabetes,it is worth further in clinical practice.