老年2型糖尿病患者胃液体排空与胃泌素、胃动素、生长抑素的关系

Relationship Between Gastric Emptying of Liquids and Serum Gastrin,Plasma Motilin,Somatostation Concentrations in Elderly Patients with Type 2 Diabetes Mellitus

目的 :探讨老年 2型糖尿病患者糖尿病性胃轻瘫的发病机制。方法 :采用实时超声显像法及放射免疫法分别测定 32例老年 2型糖尿病患者胃液体排空时间和血清胃泌素、血浆胃动素及生长抑素的浓度。结果 :老年2型糖尿病患者组胃液体排空T1 2 为 (39.2 6± 10 .85 )min ,较对照组明显延迟 (P <0 .0 1)。胃液体排空延迟的 19例 2型糖尿病患者胃泌素浓度为 (14 0 .32± 30 .75 )pg·ml- 1 ,胃动素浓度为 (6 6 7.94± 14 9.32 )pg ml- 1 、生长抑素浓度为(2 8.5 4± 8.4 6 )pg·ml- 1 ,较胃液体排空正常的 13例 2型糖尿病患者分别增高、增高及下降 (P均 <0 .0 1)。老年 2型糖尿病患者胃液体排空T1 2 与胃泌素浓度呈正相关 (r =0 .94 1) ,与胃动素浓度呈正相关 (r=0 .92 5 ) ,与生长抑素浓度呈负相关 (r=- 0 .938) ,P均 <0 .0 1。结论 :老年 2型糖尿病患者存在胃运动功能障碍 ,且胃液体排空延迟与其胃泌素分泌增高、胃动素分泌增高及生长抑素分泌下降有关 ,说明胃泌素、胃动素及生长抑素在糖尿病性胃轻瘫的发病机制中起一定作用。

Objective: To study the mechanism of gastric motor dysfunction (gastroparesis) in type 2 diabetes mellitus(DM). Methods: The gastric half emptying time of liquids and the serum gastrin,plasma motilin,somatostation concentrations were studied in 32 elderly patients with type 2 DM and 20 normal controls by real time ultrasonography and radioimmunoassay. Results: Gastric half emptying time of liquids was delayed in elderly patients with type 2 DM as compared to that of controls (P<0.01); The serum gastrin concentrations and plasma motilin concentrations increased and plasma somatostation concentrations decreased significantly of type 2 DM Group 1(patients with delayed gastric liquid emptying,n=19) than that of type 2 DM Group 2(patients with normal gastric liquid emptying,n=13); There were an excellent correlation between the gastric half emptying time and gastrin concentrations (r=0.941),motilin concentrations (r= 0.925 ),somatostations concentrations (r=-0.938) in elderly patients with type 2 DM. Conclusion: Dysfunctions of gastric motility closely correlated with the increasing of gastrin,motilin secretion and the decreasing of somatostation secretion in patients with type 2 DM. Gastrin,motilin and somatostation play important roles in the pathologenetic mechanisms of gastroparesis.