CAJ | 학술논문

临床研究发现,减重手术可以改善甚至治愈糖尿病.采用不同术式其效果不一,其中胆胰分流术(BPD)对糖尿病治愈率最高,达98％以上;其次为Roux-en-Y胃旁路术(RGBP),可达80％.但这两种手术对于治疗糖尿病的具体作用机制尚不明确,且争议较多.BPD与RGBP术后患者体内多种激素水平、尤其是肠道激素GLP-l和GIP的变化并不一致,很难用前肠及后肠假说完全解释.本综述根据国内外最新研究结果,比较了BPD及RGBP两种术式的解剖结构及术后GLP-1和GIP的变化,并对两种术式在治疗糖尿病上可能存在的不同机制进行了探讨.
림상연구발현,감중수술가이개선심지치유당뇨병.채용불동술식기효과불일,기중담이분류술(BPD)대당뇨병치유솔최고,체98％이상;기차위Roux-en-Y위방로술(RGBP),가체80％.단저량충수술대우치료당뇨병적구체작용궤제상불명학,차쟁의교다.BPD여RGBP술후환자체내다충격소수평、우기시장도격소GLP-l화GIP적변화병불일치,흔난용전장급후장가설완전해석.본종술근거국내외최신연구결과,비교료BPD급RGBP량충술식적해부결구급술후GLP-1화GIP적변화,병대량충술식재치료당뇨병상가능존재적불동궤제진행료탐토.
A large number of clinical studies indicate that bariatric surgery leads to improvement or resolution of type 2 diabetes.The outcomes vary depending on procedure adopted. Biliopancreatic diversion (BPD) is associated with the highest cure rate (98％),followed by Roux-en-Y gastric bypass (RGBP) (80％).However, the mechanisn is still unclear and controversial. The changes of many hormones after surgery are different between BPD and RGBP,especially some gastrointestinal hormones such as GLP-1 and GIP,however it cannot be fully explained by the widely known hindgut hypothesis and the foregut hypothesis.This review is intended to compare the anatomical structures and postoperative gastrointestinal hormones GLP-1 and GIP changes between the two procedures according to the latest researches in the world,and discusse different mechanisms which may take effect in improving diabetes.