上海交通大学学报（医学版）

上海交通大学学报（医学版）

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糖尿病胃轻瘫的发病机制、诊断和治疗研究进展

冯日露，麻静   

  1. 上海交通大学 医学院附属仁济医院内分泌科， 上海 200127
  • 出版日期:2016-05-28 发布日期:2016-05-26
  • 通讯作者: 麻静, 电子信箱: Cherry1996@live.cn。
  • 作者简介:冯日露（1991—）， 女， 硕士生; 电子信箱: rilu_feng@163.com。
  • 基金资助:

    上海市卫生局基金（20124273）；上海市科委基金（14441903502）；上海交通大学医学院科技基金（12XJ10015）

Research progresses in pathogenesis, diagnosis, and treatment of diabetic gastroparesis

FENG Ri-lu, MA Jing   

  1. Department of Endocrinology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2016-05-28 Published:2016-05-26
  • Supported by:

    Shanghai Municipal Health Bureau, 20124273; Science and Technology Commission of Shanghai Municipality,14441903502; Shanghai Jiao Tong University School of Medicine, Science and Technology Fund,12XJ10015

PDF (PC)

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摘要：

糖尿病胃轻瘫（DGP）是指以胃排空减慢为特征的疾患，多见于病史较长的1型及2型糖尿病患者。常见的症状有恶心、呕吐、腹胀及上腹部疼痛。胃轻瘫不仅导致患者营养不良，还会影响药物吸收，导致血糖控制不佳，影响患者的生活质量。由于发病机制不明确，临床糖尿病治疗中往往忽视胃动力的变化，因此胃轻瘫的治疗并不理想。自主神经病变及高血糖被认为是影响糖尿病患者胃肠功能紊乱的主要因素，目前的治疗主要以减轻胃肠道症状和控制血糖为主。该文结合近年来肠道动力研究的进展，对DGP的发病机制、诊断和治疗概况进行综述。

关键词: 胃轻瘫, 高血糖, 胰升糖素样肽-1, 糖尿病

Abstract:

Diabetic gastroparesis (DGP) is characterized by delayed gastric emptying in patients with prolonged type 1 and type 2 diabetes mellitus. Common symptoms include nausea, vomiting, bloating, and epigastric pain. Gastroparesis results in malnutrition, impaired drug absorption, and disordered glycaemic control and affects the quality of life. The clinical management of diabetic gastroparesis is not ideal due to unclear pathogenesis and the ignorance of changes in gastric motility. It has been recognized that autonomic neuropathy and hyperglyaemia are main contributors to the gastrointestinal dysfunction in diabetic patients. Therefore, current treatments mainly relieve gastrointestinal symptoms and control the blood sugar. Combining with progresses of intestinal motility research in recent years, this paper reviews the pathogenesis, diagnosis, and treatment of diabetic gastroparesis.

Key words:  gastroparesis, hyperglycaemia, glucagon-like peptide-1, diabetes mellitus