术前糖化血红蛋白水平对T2DM患者胃旁路术降糖效果的影响

目的探讨术前糖化血红蛋白（HbA1c）水平对Roux—en—Y胃旁路术降糖效果的影响。方法前瞻性纳入2008年1月至2009年12月收治的胃部病变合并T2DM54例，按术前HbA1c水平，将6．5％～7．9％患者分为A组，8．0％～9．9％为B组，〉10％为c组。均行Roux—en—Y胃旁路术。检测各组术前（0周）、术后12、24、48周各时间点空腹血糖（FPG）、HbA1c浓度，并分析术前（0周）及术后48周患者抗糖尿病药物使用情况。结果与术前相比，术后各组FPG、HbA1c均明显下降（P〈0．01），但各组间FPG、HbA1C差异有统计学意义（P〈0．01），伴随术前HbA1c水平的增加，术后HbA1c、FPG控制程度呈逐渐降低趋势。结论术前HbA1c〈10％时Roux—e13-Y胃旁路术降糖效果较好。

The effect of gastric bypass on type 2 diabetes mellitus patients with different preoperative glycosylated hemoglobin level

Objective To evaluate the effect of Roux-en-Y gastric bypass on patients with different preoperative glycosylated hemoglobin (HbAlc) level.Methods From Jan.2008 to Dec.2009,54 patients with gastric lesions and type 2 diabetes mellitus were preoperatively divided into 3 groups:group A (HbAlc:6.5％ -7.9％ ),group B ( HbAlc:8.0％ - 9.9％ ),and group C ( HbAlc ＞ 10％ ).They all underwent Roux-en-Y gastric bypass.The fasting plasma glucose(FPG) and HbAlc concentration were measured before surgery and 12,24,48 weeks after surgery.The antidiabetic medication was analyzed before surgery and 48 weeks after surgery.Results FPG and HbAlc concentration decreased significantly after surgery ( P ＜ 0.01 ).FPG and HbAlc concentration differed greatly between the different groups ( P ＜ 0.01 ).With the increase of preoperative HbAlc,FPG and HbAlc concentrations were poorly controlled after surgery.Conclusion Roux-en-Y gastric bypass surgery can effectively improve glucose metabolism for patients with preoperative HbAlc ＜ 10％.