世界中医药
世界中醫藥
세계중의약
WORLD CHINESE MEDICINE
2014年
9期
1181-1183
,共3页
糖尿病胃轻瘫%发病机制%诊断
糖尿病胃輕癱%髮病機製%診斷
당뇨병위경탄%발병궤제%진단
Diabetic gastroparesis%Pathogenesis%Diagnosis
目的:探讨糖尿病胃轻瘫的早期诊断方法及其发病机制。方法:选取我院收治的糖尿病患者45例,采用生化及放射免疫方法检测血糖、胃泌素、胃动素、胰高血糖素含量。采取以患者卧立位肱动脉收缩压变化检查植物神经功能;同时以标准餐加服小钡条试验检测胃排空时间,以>6 h 确诊为胃轻瘫。结果:胃排空异常者与胃排空正常者相比,空腹血糖(12.65±3.96 mmol/L&7.21±1.43 mmol/L,P <0.01)、餐后血糖(20.01±5.36 mmol/L&14.23±4.61 mmol/L,P <0.05)及糖化血红蛋白(9.81%±2.50%&7.16%±2.03%,P <0.05)明显升高,同时血清胃动素、胃泌素及胰高血糖素含量较高。胃排空异常者植物神经功能异常发生率为53.5%(15/28),而胃排空正常者仅为29.4%(5/17),糖尿病胃排空异常者胃内小钡条排空时间较正常者明显延长(7.61±1.05&4.12±0.85,P <0.001)。结论:糖尿病胃轻瘫可以综合临床症状评分、血糖及胃肠道激素等监测及影象学检查等方法进行诊断。微血管病变,高血糖、神经病变及血清胃肠激素异常等均与糖尿病胃轻瘫的发病机制密切相关。
目的:探討糖尿病胃輕癱的早期診斷方法及其髮病機製。方法:選取我院收治的糖尿病患者45例,採用生化及放射免疫方法檢測血糖、胃泌素、胃動素、胰高血糖素含量。採取以患者臥立位肱動脈收縮壓變化檢查植物神經功能;同時以標準餐加服小鋇條試驗檢測胃排空時間,以>6 h 確診為胃輕癱。結果:胃排空異常者與胃排空正常者相比,空腹血糖(12.65±3.96 mmol/L&7.21±1.43 mmol/L,P <0.01)、餐後血糖(20.01±5.36 mmol/L&14.23±4.61 mmol/L,P <0.05)及糖化血紅蛋白(9.81%±2.50%&7.16%±2.03%,P <0.05)明顯升高,同時血清胃動素、胃泌素及胰高血糖素含量較高。胃排空異常者植物神經功能異常髮生率為53.5%(15/28),而胃排空正常者僅為29.4%(5/17),糖尿病胃排空異常者胃內小鋇條排空時間較正常者明顯延長(7.61±1.05&4.12±0.85,P <0.001)。結論:糖尿病胃輕癱可以綜閤臨床癥狀評分、血糖及胃腸道激素等鑑測及影象學檢查等方法進行診斷。微血管病變,高血糖、神經病變及血清胃腸激素異常等均與糖尿病胃輕癱的髮病機製密切相關。
목적:탐토당뇨병위경탄적조기진단방법급기발병궤제。방법:선취아원수치적당뇨병환자45례,채용생화급방사면역방법검측혈당、위비소、위동소、이고혈당소함량。채취이환자와립위굉동맥수축압변화검사식물신경공능;동시이표준찬가복소패조시험검측위배공시간,이>6 h 학진위위경탄。결과:위배공이상자여위배공정상자상비,공복혈당(12.65±3.96 mmol/L&7.21±1.43 mmol/L,P <0.01)、찬후혈당(20.01±5.36 mmol/L&14.23±4.61 mmol/L,P <0.05)급당화혈홍단백(9.81%±2.50%&7.16%±2.03%,P <0.05)명현승고,동시혈청위동소、위비소급이고혈당소함량교고。위배공이상자식물신경공능이상발생솔위53.5%(15/28),이위배공정상자부위29.4%(5/17),당뇨병위배공이상자위내소패조배공시간교정상자명현연장(7.61±1.05&4.12±0.85,P <0.001)。결론:당뇨병위경탄가이종합림상증상평분、혈당급위장도격소등감측급영상학검사등방법진행진단。미혈관병변,고혈당、신경병변급혈청위장격소이상등균여당뇨병위경탄적발병궤제밀절상관。
Objective:To explore the clinical diagnosis and the pathogenic mechanisms of diabetic gastroparesis.Methods:A total num-ber of 45 in-hospital patients with diabetes were chose in this study.Bbiochemical method and radioimmunoassay (RIA)were used to de-tect the 1evels of plasma glucoses,glycosylated hemoglobin (GHG),gastrin,motilin and glucagons.The autonomic nerve function and barium strip emptying time (>6h)were used to diagnose the diabetic gastroparesis.Results:The levels of the blood glucose (FBG), postprandial blood glucose(PBG)and GHG were obvious higher in diabetic patients with abnormal gastric emptying than those with nor-mal gastric emptying(FBG:12.65 ±3.96 mmol/L&7.21 ±1.43 mmol/L,P <0.01;PBG:20.01 ±5.36 mmol/L&14.23 ±4.61 mmol/L,P <0.05;GHG:9.81% ±2.50% &7.16% ±2.03%,P <0.05).Meanwhile,higher levels of serum motilin,gastrin,and glucagons were detected in diabetic patients with abnormal gastric emptying.The incidence rate of autonomic nerve function abnormality was 53. 5% (15 /28)in diabetic patients with abnormal gastric emptying,higher than those with normal gastric emptying 53.5%(15 /28).The barium strip emptying time was obvious prolonged in patients with diabetic gastroparesis (7.61 ±1.05h&4.12 ±0.85h,P <0.001). Conclusion:Diabetic gastroparesis can be comprehensively diagnosed by grading clinical symptom,examining plasma glucoses,gastrin, motilin and glucagons,evaluating autonomic nerve function and barium emptying time.Hyperglycaemia,gut hormone abnormality,neu-ropathy,and microangiopathy were relevant to the diabetic gastroparesis.