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糖尿病患者消化间期移行性复合运动规律的研究

The study of migrating motor complex in type Ⅱ diabetes

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【作者】 王雁袁申元张建忠胡鸿英肖作亮付汉菁万小平朱良湘

【Author】 Wang Yan, Yuan Shenyuan, Zhang Jianzhong, et al. Department of Gastroenterology,Tongren Hospital,Beijing 100730

【机构】 北京同仁医院消化内科

【摘要】 目的探讨糖尿病患者消化间期移行性复合运动(MMC)的规律。方法应用胃十二指肠测压技术对51例Ⅱ型糖尿病患者和15名健康志愿者进行了MMC检测,测定时间为240~360分钟。结果糖尿病患者MMCⅢ期正常者仅27.5%,明显低于对照组(73.4%,P值<0.01),其中MMCⅢ期缺失者占41.1%(对照组为13.3%,P值<0.01)。糖尿病组MMCⅢ期胃窦部收缩波幅较对照组减低(P值<0.05)。MMC各期持续时间个体差异较大,糖尿病组与对照组相比表现为Ⅱ期延长(P值<0.01)。结论本研究提示约70%糖尿病患者在未出现消化系统症状之前已表现为MMC异常,胃十二指肠测压为糖尿病胃肠运动功能障碍、尤其是糖尿病胃轻瘫的早期诊断和治疗提供了有效的手段。

【Abstract】 Objective To investigate the characteristics of migrating motor complex (MMC) in diabetic patients. Methods 51 typeⅡ diabetes (NIDDM) patients and 15 healthy volunteers were studied after an overnight fast by means of 6 channel computerized manometry of antroduodenal region for at least 240 min. Results The results showed that phase Ⅲ of the MMC originated in the antrum in 14/51 (27.5%) of the diabetic patients, which was significantly decreased than that in 11/15 (73.4%) of the normal controls ( P <0.01). PhaseⅢ were absent in 21/51 (41.1%)of the patients and in 2/15 (13.3%) of the controls ( P <0.05).The amplitude of phaseⅢ in antrum was lower in the diabetic group than that in the control (8.1±3.5 kPa vs 10.5±3.1 kPa, P <0.05). Period of phase Ⅱ was also prolonged in the diabetes patients than normal subjects (27.94±13.14 min vs 19.93±6.09 min, P <0.01).PhaseⅡ and phaseⅢ were all absent in 6/51 (11.8%) of the diabetic patients during 240 min , but it has not been seen in the controls.There was no significant relationship between these abnormalities of MMC and the diabetic duration or complications (nervous,renal, cardiovascular,etc). Conclusion The results of this study demonstrated that about 70% NIDDM patients had abnormal MMC even before the clinical symptoms of gastroparesis occured, and the gastroduodenal manometry may be an useful method in the early diagnosis and treatment of diabetic gastroparesis.

  • 【文献出处】 中华内科杂志 ,CHINESE JOURNAL OF INTERNAL MEDICINE , 编辑部邮箱 ,1998年08期
  • 【分类号】R587.1
  • 【被引频次】25
  • 【下载频次】78
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