腹腔镜Roux-en-Y胃旁路术对不同体重指数2型糖尿病疗效分析

Therapeutic effects of laparoscopic Roux-en-Y gastric bypass on T2DM patients with different BMI

目的 探讨腹腔镜Roux-en-Y胃旁路术治疗不同体重指数（BMI）的T2DM临床疗效。方法 回顾郑州市第二人民医院腹腔镜Roux-en-Y胃旁路术治疗T2DM 62例的临床资料，按BMI（kg／m^2）25-28、28-33，≥33分别作为低BMI组、中BMI组、高BMI组，通过随访监测，分析其临床疗效。结果术后12个月，中BMI组和高BMI组的总胆固醇（TC）、甘油三酯（TG）、BMI与术前比较差异有统计学意义（P〈O.05）；术后12个月，低、中、高BMI 3组T2DM治疗有效率（完全缓解率＋部分缓解＋明显改善）分别为81.8％（9／11）、97.4％（38／39）、100％（12／12）；高BMI组患者空腹C肽和餐后1 h C肽在术后12个月同术前比较差异有统计学意义（P〈0.05）。结论腹腔镜Roux-en-Y胃旁路术对不同BMI的T2DM均有较好的临床疗效，但是对于低BMI的糖尿病患者行腹腔镜Roux-e-Y胃旁路术需更严格的筛选和慎重的考虑。

Objective To investigate the clinical efficacy of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus（T2DM） with different body mass index （BMI）. Methods 62 T2DM patients were collected and divided into low BMI, medium BMI, and high BMI groups respectively according to BMI 25-28 （kg/m2）, 28-33（kg/m2）, ≥33（kg/m2）. All patients received laparoscopic Roux-en-Y gastric bypass and the clinical curative effects were monitored and analyzed subsequently. Results At 12 months postoperatively, the levels of total cholesterol（TC）, triglyceride（TG） and BMI in medium and high BMI group were lower compared with those before surgery （P〈0.05）. In low, medium BML and high BMI groups, the therapeutic effective rate was 81.8%（9/11 ）, 97.4% （38/39）, and 100% （12/12） respectively. The levels of fasting Cpeptide and postprandial 1 h Cpeptide were higher compared with those before surgery （P〈0.05）. Conclusion Laparoscopic Roux-en-Y gastric bypass has good clinical curative effect for T2DM with different BMI, but for low BMI patients, the selection should be more cautious.