有消化道症状糖尿病患者近端胃功能与血糖的关系

Relationship between proximal gastric function and blood glucose in diabetic patients with and without gastrointestinal symptoms

目的观察有无消化道症状糖尿病(diabetes mellitus,DM)患者近端胃功能特点;了解有或无消化道症状的DM患者血糖控制情况;研究血糖对DM患者近端胃功能的互相影响.方法 54例DM患者,男性24人,女性30人,平均年龄61.3岁±11.9岁,所有受试者均除外胃肠道器质性疾病,根据DM上消化道症状的有无将之分为二组:无消化道症状DM组(n=26)及有胃肠症状DM组(n=28),受试者行饮水试验,并用B超分别测量两次饮水后近端胃及远端胃的周长与面积;同一天测空腹、餐后血糖及糖化血红蛋白.结果 (1)有胃肠症状组饮水差值、胃底面积差值、胃底周长差值显著低于无症状组,其饱感阈值饮水量、最大耐受饮水量显著低于无症状组;(2)有胃肠症状组空腹血糖及糖化血红蛋白明显高于无症状组组;(3)有症状组饱感阈值与空腹血糖、餐后血糖及GHb均成负相关;最大耐受饮水量与餐后血糖及GHb值成负相关.结论 DM患者存在近端胃功能损害;有上消化道症状DM患者血糖控制情况差于无症状组;血糖控制不良可能影响患者近端胃功能.

AIM To evaluate the effect of blood glucose on proximal stomach function in diabetic patients with and without gastrointestinal symptoms.METHODS Fifty-four patients with DM were included in this study, including 24 males and 30 females, with a mean age of 61.3 years ± 11.9 years. None of the subjects had any organic gastrointestinal disease. The patients were divided into two groups： those with gastrointestinal symptoms（n = 28） and those without（n = 26）. Water load test was performed to determine the function of the proximal stomach. Fasting blood glucose（FBG）, postprandial blood glucose（PBG）, and glycated hemoglobin（GHb） were also measured.RESULTS FBG and GHb were significantly higher in patients with gastrointestinal symptoms than in those without（P〈0.05）. There was a negative correlation between threshold drinking volume and FBG, PBG, or GHb in patients with gastrointestinal symptoms（r =-0.44,-0.46, and-0.64, respectively, P〈0.05）. There was a negative correlation between satiety drinking volume and PBG or GHb（r =-0.46 and-0.60, respectively）. CONCLUSION High blood glucose might play a role in proximal gastric dysfunction in diabetic patients.