糖尿病(DM)不同阶段胃动力紊乱研究

The Study of GI Motility Disorder Diabetes Mellitus in Different Stages

目的探讨糖尿病(DM)在不同阶段胃动力紊乱产生的规律.方法已确诊糖尿病病人27例,糖尿病病人按其有无胃肠症状及其他糖尿病合并症分为两组,有胃肠症状同时伴有其他糖尿病合并症组18例,无胃肠症状组9例,同时选20例正常人作对照.用核素法对糖尿病(DM)不同阶段胃排空功能的变化进行观察.结果有胃肠症状或合并其他脏器并发症的DM病人120 min近端胃存留率为(33.72±3.6)%,较正常人(23.16±2.02)%(P=0.08)及无胃肠症状DM病人(17.54±3.08)%(P＜0.005)增加,全胃和近端胃t1/2分别为(91.46±9.28)min和(81.87±8.24)min,比正常人的(55.7±3.68)min(P＜0.005)和(50.29±3.51)min(P＜0.01)明显延长;早期无胃肠症状或仅有轻度三多一少症状的DM病人的近端胃排空速率为(1.10±0.12)%,与正常人(0.08±0.04)%相比明显增加(P＜0.05),120min近端胃存留率为(17.54±3.08)%,与正常人的(23.16±2.02)%比较明显减少(P=0.06).结论不同阶段糖尿病患者胃排空功能状态不同,DM胃排空异常可能从近端胃开始.

Objective To study GI motility disorder diabetes mellitus in different stages.Methods 27 cases of DM are divided into 18 cases of symptomatic of GI, 9 cases of asymptomatic of GI, 20 cases of control. We determined gastrical emptying by radiopaque marker.Results Remaining of proximal stomach at end of 120?min were(33.72±3.68)% (vs control, P =0.08),(17.54±3.08)% (vs control, NS, vs symptomatic DM, P <0.005) and(23.16±2.02)% in symptomatic DM, asymptomaric and control group,respectively. It increased in symptomatic DM patients. t 1/2 of total and proximal stomach were (91.46±9.28)min ( P <0.005) and (81.87±8.24)min ( P <0.01) in symptomatic DM and (55.7±3.68)min and (50.29±3.51)min in control. Velocity of proximal stomach in asymptomatic patient was (1.10±0.12)/min, it was significant increased compared with in control (0.82±0.04)/min, P <0.05). Remaining of proximal stomach at the end of 120?min decreased in this group with(17.54±3.08)% ( P =0.06) compared with( 23.16 ±2.02)% in control.Conclusion There were diffierent patterns of gastric content emptying in difierent stages of diabetes:there were normal or accelerated GE of proximal stomach in asymptcroatic patient with DM,and show as delayed, accelerated or normal gastric emptying in symptomatic patient.