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目的探讨2型糖尿病(T2DM)患者胃旁路术(GBP)后的糖代谢变化规律。方法 2006年1月至2007年6月期间,我院普外科住院的129例T2DM患者,按HbA,c分为:A组,HbAl c 7%～7.9%;B组,HbA_1c 8%～9%;C组,HbA_1c>9%。三组患者均实施GBP手术,术前和术后1、3、6、12个月检奄OGTT、胰岛素释放试验、C-P释放试验、HbA_1c和BMI,计算胰岛素分泌指数,术后随访1年。结果 (1)与术前相比,术后各组BMI呈下降趋势,c组术后明显降低,差异有统计学意义(P<0.01);(2)与术前相比,术后FPG水平逐渐下降至术后12个月,差异有统计学意义(P%0.01);(3)术后各组Fins水平无统计学差异;(4)与术前相比,A组术后12个月FC-P水平明显升高(P=0.006);(5)与术前相比,术后HbA_1c逐渐下降,术后12个月差异有统计学意义(P均<0.01);(6)与术前相比,A组术后12个月△I_(30)明显改善(P<0.01)。结论 GBP后T2DM患者糖代谢明显改善。
Objective To investigate the changes of glucose metabolism after gastric bypass (GBP) in type 2 diabetes mellitus (T2DM). Methods From January 2006 to June 2007, 129 patients with T2DM hospitalized in general surgery in our hospital were divided into: group A, HbAl c 7% ~ 7.9%; group B, HbA 1c 8% ~ 9% ; Group C, HbA_1c> 9%. Three groups of patients underwent GBP operation. OGTT, insulin release test, C-P release test, HbA 1c and BMI were performed before operation and 1, 3, 6 and 12 months after operation. Insulin secretion index was calculated and was followed up for 1 year. Results (1) Compared with preoperative, the BMI of each group showed a decreasing trend after operation, and the postoperative C group decreased significantly (P <0.01). (2) The postoperative FPG level (P <0.01). (3) There was no significant difference in the level of Fins between groups after operation (4) Compared with preoperative, group A showed no significant difference in 12 months after operation (P = 0.006). (5) Compared with preoperative, the level of HbA 1c decreased gradually and the difference was statistically significant at 12 months (all P <0.01); (6) Compared with before treatment, the △ I_ (30) in group A at 12 months after operation was significantly improved (P <0.01). Conclusion The glucose metabolism in patients with T2DM after GBP significantly improved.