胃旁路术联合营养干预对肥胖型2型糖尿病的疗效观察

目的观察胃旁路术（gastric bypass,GBP）联合营养干预,对肥胖型2型糖尿病（type 2diabetes mellitus,T2DM）的疗效。方法 76例实施GBP的肥胖型T2DM患者,随机分为联合营养治疗组与对照组,每组38例。于术后3个月、6个月观察其糖代谢、胰岛细胞功能、营养状态等相关指标和并发症。结果术后,患者临床完全缓解率为84.21%（64/76）,部分缓解率15.79%（12/76）;两组空腹血糖（fasting blood glucose,FBG）、糖化血红蛋白（glycosylatedhemoglobin,HbA1c）、血清铁水平显著下降（P〈0.01）,空腹胰岛素和空腹C肽显著升高（P〈0.01）。与对照组比较：联合营养治疗组血清铁、血清铁蛋白水平显著升高（P〈0.01）;脱发、贫血等发生率显著减少（P〈0.05）。结论GBP对肥胖型T2DM病情控制疗效满意;联合营养治疗可维持GBP患者更好的营养状态,并显著减少其并发症的发生。

Therapeutic Effects of Laparoscopic Gastric Bypass and Nutritional Intervention on Type 2 Diabetes Mellitus

Objective To observe the therapeutic effects of laparoscopic Roux-en-Y gastric bypass and nutritional intervention in type 2 diabetes mellitus （T2DM）. Methods A total of 76 T2DM patients were randomly assigned into treatment group and control group B with or without nutritional supplements. Three months and six months after the sur- gery, the index of glycometabolism, islet cell function, nutrition status, and other related indicators or complications were observed and recorded. Results After surgery, the clinical complete remission rate was 84. 21% （64/76）, and the partial remission rate was 15.79% （12/76）. In both groups the levels of fasting blood glucose, glycated hemoglobin and serum i- ron levels were decreased （P〈0. 01）, the fasting insulin and C peptide were increased （P〈0. 01）. Compared with the control group, the serum iron and ferritin levels were significantly increased （P〈0. 01）, the incidence of alopecia and a- nemia were lower （P〈0. 05）. Conclusion Therapeutic effect of laparoscopic Roux-en-Y gastric bypass on T2DM is sat- isfactory. Nutritional interventions helps the patients to maintain good nutrition status, and can reduce the occurrence of the complications