糖尿病胃轻瘫胃排空状态与肾功能水平的关系研究

The relationship between gastric emptying and renal function in diabetic gastroparesis

目的研究糖尿病胃轻瘫胃排空状态与肾功能的关系。方法纳入2017年4月至2018年4月青海大学附属医院40例2型糖尿病(T2DM)患者作为观察组,根据是否发生糖尿病性胃轻瘫(DGP)将观察组分为A组(发生胃轻瘫)和B组(未发生胃轻瘫),另纳入同期40例体检健康者作为对照组。记录80例研究对象的血肌酐(Scr)、肾小球滤过率(eGFR)水平及胃半排空时间(GET1/2)。比较观察组与对照组胃排空时间Scr、eGFR及GET1/2水平,分析GET1/2与Scr和eGFR的关系。结果观察组Scr显著高于对照组,GET1/2较对照组显著延长,eGFR显著低于对照组(P均<0. 05)。A组Scr和GET1/2显著高于B组,eGFR显著低于B组(P均<0. 05)。GET1/2与Scr呈正相关性(r=0. 385,P=0. 000),与eGFR呈负相关性(r=-0. 802,P=0. 000)。Scr判断DGP的AUC为0. 720(β=0. 080,95%CL 0. 563-0. 877,P=0. 019),敏感度为0. 841,特异度为0. 435。eGFR判断DGP的AUC为0. 812(β=0. 068,95%CL 0. 679-0. 945,P=0. 001),敏感度为0. 824,特异度为0. 745。结论DGP与肾功能损伤具有一定关系,临床监测eGFR和Scr有助于早期筛查DGP。

Objective To study the relationship between gastric emptying and renal function in diabetic gastroparesis.Methods 40 patients with type 2 diabetes mellitus(T2DM)from April 2017 to April 2018 in our hospital were selected as the observation group,The observation group was divided into group A(gastroparesis and group B no gastroparesis which accorded to the occurrence of diabetic gastroparesis DGP.40 healthy persons in the same period were selected as control group another.The serum creatinine Scr glomerular filtration rate eGFR and gastric half emptying time GET1/2 were recorded in 80 subjects.The gastric emptying time levels of Scr eGFR and GET1/2 were compared between the observation group and the control group and the relationship between GET1/2 Scr and eGFR were analyzed.Results The Scr of observation group was significantly higher than that of control group the GET1/2 was significantly longer than that of control group the eGFR was significantly lower than that of control group the difference were statistically significant P<0.05.The Scr and GET1/2 in group A were significantly higher than those in group B and eGFR was significantly lower than those in group B the difference were statistically significant P<0.05.There was a significant positive correlation between GET1/2 and Scr r=0.385 P=0.000 and there was a negative correlation with eGFR r=-0.802 P=0.000.The Scr judged that the AUC of DGP was 0.720β=0.080 95%CL 0.563-0.877 P=0.019 the sensitivity was 0.841 and the specificity was 0.435.The EGFR judged the AUC of DGP was 0.812β=0.068 95%CL 0.679-0.945 P=0.001 the sensitivity was 0.824 and the specificity was 0.745.Conclusion The DGP is related to renal function injury.It s helpful for early screening of DGP by clinical monitoring of eGFR and Scr.