Roux.en—Y胃肠转流术对胃癌合并2型糖尿病患者胰岛功能的影响 |
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引用本文: | 崔海滨,付冬霞,白希永,葛怀娥,张维,魏晓楠. Roux.en—Y胃肠转流术对胃癌合并2型糖尿病患者胰岛功能的影响[J]. 中国综合临床, 2014, 0(1): 79-81 |
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作者姓名: | 崔海滨 付冬霞 白希永 葛怀娥 张维 魏晓楠 |
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作者单位: | 河北省沧州市中心医院肿瘤外一科,061001 |
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摘 要: | 目的探讨Roux.en.Y胃肠转流术对胃癌合并2型糖尿病患者血糖及胰岛功能的影响。方法选择我院行Roux-en—Y胃肠转流术治疗的27例胃癌合并2型糖尿病患者,比较术前及术后3、6个月的体质量指数(BMI)、糖化血红蛋白(HbAlC)、空腹血糖(FPG)、空腹胰岛素(FINS)、空腹c肽(FCP)的浓度,检测并比较3个时间点口服75g葡萄糖2h后的血糖(2hPG)、胰岛素(2hlNS)及c肽(2hCP)水平,采用稳态模式评估法评价胰岛素抵抗指数(HOMA-IR)。结果术后BMI无明显变化;术后3个月FPG、2hPG、HbAlc、HOMA—IR[分别为:(7.58±0.84)mmol/L、(10.43.4-1.88)mmol/L、(7.56±1.15)%、4.55±0.76]均较术前显著下降[(9.93±1.57)mmol/L、(13.89±2.13)mmo]/L、(9.88.4-1.66)%、5.06±1.13],手术前后比较差异均有统计学意义(P〈0.05或P〈0.01);术后6个月FPG为(6.56±0.80)mmol/L,2hPG为(8.574-1.32)mmol/L,HbAlC为(6.374-1.24)%以及HOMA-IR为4.03±0.45,亦均低于术前、术后3个月(P〈0.05或P〈0.01)。但术后3个月的FINS、FCP、2hlNS、2hCP[分别为:(13.674-1.96)mU/L、(2.62-4-0.87)斗g/L、(49.91±5.14)mU/L、(6.28±1.65)ug/L]均较术前[分别为(11.08±1.69)mU/L、(1.78±0.61)¨g/L、(36.05±4.03)mU/L、(4.284-1.48)ug/L]明显升高,差异均有统计学意义(P均〈0.01);术后6个月[FINS:(15.884-2.05)mU/L、FCP:(3.30±0.68)斗g/L、2hlNS:(67.40±5.68)mU/L、2hCP:(9.39.4-1.52)ug/L]均高于术前和术后3个月(P均〈0.01)。结论采用Roux-en.Y胃肠转流术能有效降低胃癌合并2型糖尿病患者的血糖水平,明显改善胰岛B细胞功能。
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关 键 词: | 胃癌 胃肠转流术 2型糖尿病 胰岛功能 |
Effect of Roux-en-Y gastric gastrointestinal bypass surgery on islet function of patients with type-2diabetes mellitus pancreatic |
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Affiliation: | Cui Haibin, Fu Dongxia, Bai Xiyong, Ge H uaie, Zhang Wei, Wei Xiaonar Oncology Department, Cangzhou Centeral Hospital, Cangzhou 061001, China Corresponding author: Cui Haibin , Email : chess_chb @ 126. corn |
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Abstract: | Objective To investigate the effect of gastrointestinal Roux-en-Y gastric bypass surgery on blood sugar and insulin function of patients with type-2 diabetes mellitus. Methods Twenty-seven cases of gastric cancer patients with type:2 diabetes and undergone Roux-en-Y bypass the gastrointestinal treatment in the centre hospital of Cangzhou were selected as our subject. Body mass index ( BMI ), Glycosylated hemoglobin ( HBAlc), Fasting and glucose ( FPG ), fasting insulin ( FINS ), Fasting C-peptide (. FCP ) levels were measured. Glucose(2 hPG) ,insulin (2 bINS)and C-peptide(2 bCP) levels were detected after 2 h for oral use 75 g glucose. Homeostasis model was applied to assess insulin resistance index( HOMA-IR). Results No significant change was seen in terms of BMI between before and after surgery. Compared to before surgery, the levels of FPG ( (7. 58 ± 0. 84 ) mmol/L), 2 hPG ( ( 10. 43 ±1.88 ) mmol/L), HbA1 c ( (7. 56 + 1. 15 ) % ) and HOMA-IR(4. 55 s0.76) were lower in patients at 3 months after surgery ( (9. 93 ± 1.57) retool/L, ( 13.89 ± 2. 13) mmol/L, ( 9. 88 ± 1.66 ) %, ( 4. 55±0. 76 ), respeetively, P 〈 0. 05 or P 〈 0. 01 ). FPG ( ( 6. 56 sO. 80) mmol/L) ,2 hPG ( (8. 57 ±1. 32) mm01/L) ,HbAlc( (6. 37 ± 1.24)% ), HOMA-IR(4. 03 sO. 45) of patients after 6 months were lower than that of before surgery and 3 months after surgery ( P 〈 O. 05 or P 〈0. O1 ). However,the levels of FINS ( ( 13.67 ± 1.96) mU/L) ,FCP( (2. 62 sO. 87) ug/L) ,2 hINS( (49.91±5. 14) mU/L) and 2 hCP ((6. 28 ~ 1.65) p,g/L) were higher in patients with 3 months after surgery compared to that of before surgery ((11.08 ~ 1.69) mU/L, (1.78 ~0.61) ug/L, (36.05 ±4.03) mU/L, (4. 28 ~ 1.48) p,g/L, P 〈 0. 01 ). Meanwhile those indices after 6 months ( FINS : ( 15.88 ± 2. 05 ) mU/L, FCP: (3.30 sO. 68) p~g/L,2 hlNS: (67. 40 ±5. 68) mU/L,2 hCP: (9. 39 ± 1.52) ug/L) were higher than that ofbefore surgery and 3 months after surgery ( P 〈 0. 01 ). Conclusion Roux-en-Y gastrointestinal bypass can effectively reduce blood sugar level and improve the situation of Pancreatic Beta-cell function of gastric cancer patients with type-2 diabetes. |
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Keywords: | Stomach neoplasms Gastric bypass Type-2 diabetes mellitus Pancreatic function |
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