Abstract:

【Abstract】〓Objective〓To observe the effects of Roux-en-Y gastric gastrointestinal reconstruction surgery on blood glucose and insulin resistance of patients with gastric carcinoma complicated by type 2 diabetes. Methods〓Thirty-one patients with gastric carcinoma complicated by type 2 diabetes who underwent radical gastrectomy and Roux-en-Y gastric gastrointestinal reconstruction were collected. The weight, body mass index (BMI), fasting blood glucose (FPG), fasting insulin (FINS), fasting C peptide (FCP), 2 hour postprandial blood glucose (2hPG), 2 hour postprandial insulin (2hINS), 2 hour postprandial C peptide (2hCP), glycosylated hemoglobin (HbA1c) and insulin resistance index (HOMA-IR) were detected, the index changes were estimated before operation and six months after the operation. Results〓Of 31 cases, 27 patients received insulins treatment, 2 patients with oral medication and 2 with simple diet and exercise therapy before operation, and 14 patients with insulin treatment, 6 with oral medication and 11 with simple diet and exercise therapy at six months after the operation. The difference was statistically significant betwee pre- and post-operation. (P<0.05). The weight, BMI, FPG, FINS, 2hPG, 2hINS, HbA1c and HOMA-IR in patients at six months after the operation were lower than those in patients before operation (P<0.05). The FCP and 2h CP levels in patients at six months after the operation were higher than patients before operation (P<0.05). Conclusion〓Roux-en-Y gastric gastrointestinal reconstruction can improve blood glucose and insulin resistance in patients with gastric carcinoma complicated by type 2 diabetes.

Key words: Insulin resistance, Gastric gastrointestinal reconstruction, Blood glucose, Diabetes, Stomach neoplasms

摘要：

【摘要】〓目的〓探讨Roux?鄄en?鄄Y消化道重建手术对胃癌合并糖尿病患者血糖控制及胰岛素抵抗的影响。方法〓选择我院普外科住院的胃癌合并2型糖尿病患者31例,行胃癌根治及Roux?鄄en?鄄Y吻合消化道重建术,对比患者术前及术后6个月体重、体质指数(BMI)、空腹血糖(FPG)、空腹胰岛素(FINS)、空腹C肽(FCP0、餐后2小时血糖(2hPG)、餐后2小时胰岛素(2hINS)、餐后2小时C肽(2hCP)、糖化血红蛋白(HbA1c)及胰岛素抵抗指数(HOMA?鄄IR)等指标变化。结果〓术前31例患者中27例给予胰岛素治疗,2例给予口服药物治疗,2例给予单纯饮食运动控制血糖。术后6个月随访,14例患者继续给予胰岛素治疗,6例口服药物治疗,11例未使用任何降糖药物单纯饮食运动控制血糖良好,术前与术后间差异有统计学意义(P<0.05)。术后6个月研究对象体重、BMI、FPG、2hPG、FINS、2hINS、HbA1c及HOMA?鄄IR均明显低于术前水平(P<0.05),但术后6个月患者FCP及2hCP水平高于术前(P<0.05)。结论〓Roux?鄄en?鄄Y胃肠道重建术能改善胃癌合并2型糖尿病患者的血糖控制,减轻胰岛素抵抗。

关键词: 糖尿病, 血糖, 胃癌, 胰岛素抵抗, 胃肠道重建手术