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目的 了解在糖尿病 (DM )不同阶段胃运动功能的变化及其血糖对胃运动的影响。方法 健康组 (HS) 2 0例 ,2型糖尿病组 4 7例 [包括无胃肠症状者 12例 ,有胃肠症状和 (或 )DM并发症者 3 5例 ]。采用核素法测定胃排空 ,并同时测空腹和餐后 2h血糖 ,分析高血糖对胃排空的影响。结果 有胃肠症状或DM并发症患者 12 0min近端胃存留率较健康组增加 ,全胃T1/ 2 比健康组明显延长 ;无胃肠症状的DM患者 12 0min近端胃存留率减少 ,近端胃排空速率明显增加。有胃肠症状DM患者远端胃放射性计数明显增加 ,食物在胃内分布异常 ;有胃肠症状DM患者血糖与胃排空指标之间无明显相关性 ;而无胃肠症状DM患者血糖与胃存留率呈负相关。结论 不同阶段糖尿病患者胃排空功能状态不同 ,早期胃排空正常或有近端胃排空加速 ,后期则以排空延迟为主要形式。食物在胃内分布异常是造成DM患者症状的原因之一。推测高血糖加速早期DM胃排空 ,而DM后期ENS及神经病变等占重要地位。
Objective To understand the changes of gastric motor function and the effect of blood glucose on gastric motility at different stages of diabetes mellitus (DM). Methods 20 cases of healthy group (HS) and 47 cases of type 2 diabetes mellitus (including 12 cases without gastrointestinal symptoms, 35 cases with gastrointestinal symptoms and / or DM complications]. The gastric emptying was measured by radionuclide and the fasting and postprandial 2h blood glucose were measured at the same time, and the effect of hyperglycemia on gastric emptying was analyzed. Results The patients with gastrointestinal symptoms or DM complications had a higher rate of proximal gastric retention at 120 min than the healthy group, and T1 / 2 of the whole stomach was significantly longer than the healthy group. The gastric residual rate at 120 min without gastrointestinal symptoms was reduced Gastric emptying rate was significantly increased. Gastrointestinal symptoms in patients with DM distal gastric radioactivity increased significantly, the distribution of food in the stomach abnormalities; DM patients with gastrointestinal symptoms of blood glucose and gastric emptying no significant correlation between; without gastrointestinal symptoms of DM patients with blood glucose and stomach Retention rate was negatively correlated. Conclusion Different stages of gastric emptying function in patients with different status, normal early gastric emptying or gastric emptying accelerated, the latter part of the delay is the main form of emptying. Abnormal distribution of food in the stomach is one of the causes of DM symptoms. It is hypothesized that hyperglycemia accelerates early DM gastric emptying, while late stage of DM and neuropathy occupy an important position.