超声所测全胃容积评估糖尿病患者胃功能的初步探索

Evaluation of gastric function in diabetic patients with the volume of the whole stomach measured by ultrasound:a preliminary study

目的应用二维超声测量全胃容积(VWS),探讨其评估糖尿病患者胃容受功能的临床价值,分析其相关影响因素。方法选取我院121例糖尿病患者(糖尿病组)和99例健康志愿者(健康对照组),均于饮入500 ml温水后应用二维超声扫查充盈后的胃腔,测量胃底面积(FA)、胃体面积(BA)和长径(BL)、胃窦面积(AA)和长径(AL),并计算VWS。比较糖尿病组与健康对照组、不同临床资料[性别、年龄、体质量指数(BMI)、空腹血糖(FPG)及糖化血红蛋白(HbA1c)]的糖尿病患者VWS相关超声参数的差异;分析VWS与性别、年龄、BMI、FPG及HbA1c的相关性。结果糖尿病组FA、BL、BA、AA、VWS均小于健康对照组,差异均有统计学意义(均P<0.05)。对不同临床资料的糖尿病患者分组比较:①男性组与女性组FA、VWS比较,差异均有统计学意义(均P<0.05);BL、BA、AL、AA比较,差异均无统计学意义。②不同FPG水平糖尿病患者FA、BA、VWS比较,差异均有统计学意义(均P<0.05)。两两比较显示,与FPG<7mmol/L组、7 mmol/L≤FPG<10mmol/L组比较,FPG≥10mmol/L组FA、BA、VWS均减小(均P<0.05);与FPG<7mmol/L组比较,7mmol/L≤FPG<10 mmol/L组FA、VWS均减小(均P<0.05)。③不同年龄、BMI、HbA1c水平的糖尿病患者各超声参数比较,差异均无统计学意义。相关性分析显示,VWS与FPG呈负相关(r_(s)=-0.411,P<0.01),与性别、年龄、BMI及HbA1c均无相关性。结论二维超声所测VWS有望成为评估糖尿病患者胃容受功能的有效指标,且FPG是糖尿病患者VWS的主要影响因素。

Objective To investigate the clinical value of the volume of the whole stomach(VWS)measured by two-dimensional ultrasound in evaluating gastric accommodation function in diabetic patients,and to analyze its related influencing factors.Methods A total of 121 diabetic patients(diabetic group)and 99 healthy volunteers(healthy control group)in our hospital were selected.After drinking 500 ml warm water,the filled gastric cavity was examined by two-dimensional ultrasound.The area of gastric fundus(FA),the area and long diameter of gastric body(BA,BL),and the area and long diameter of gastric antrum(AA,AL)were measured,and VWS was calculated.The differences of VWS-related ultrasound parameters in diabetic patients with different clinical data[gender,age,body mass index(BMI),fasting plasma glucose(FPG)and glycosylated hemoglobin(HbA1c)]were compared between the diabetic group and the healthy control group.The correlation between VWS and gender,age,BMI,FPG and HbA1c was analyzed.Results FA,BL,BA,AA and VWS in the diabetic group were lower than those in the healthy control group,and the differences were statistically significant(all P<0.05).Comparison of diabetic patients with different clinical data:①There were statistically significant differences in FA and VWS between female group and male group(all P<0.05),while there were no significant difference in BL,BA,AL and AA.②There were statistically significant differences in FA,BA and VWS among diabetic patients with different FPG levels(all P<0.05).Compared with FPG<7 mmol/L group and 7 mmol/L≤FPG<10 mmol/L group,FA,BA and VWS in FPG≥10 mmol/L group were decreased(all P<0.05).Compared with FPG<7 mmol/L group,FA and VWS in 7 mmol/L≤FPG<10 mmol/L group were decreased(all P<0.05).③There were no significant difference in the ultrasound parameters of diabetic patients with different age,BMI and HbA1c levels.Correlation analysis showed that VWS was negatively correlated with FPG(r_(s)=-0.411,P<0.01),but had no correlation with gender,age,BMI and HbA1c.Conclusion Two-dimensional ultrasound measurement of VWS is expected to be an effective indicator for evaluating gastric accommodation function in diabetic patients,with FPG being the main influencing factor of VWS.