上海交通大学学报（医学版）

上海交通大学学报(医学版) ›› 2020, Vol. 40 ›› Issue (09): 1249-1255.doi: 10.3969/j.issn.1674-8115.2020.09.014

• 论著·临床研究 • 上一篇    下一篇

糖尿病患者胃排空速率的临床观察

蒋毅弘1，刘 伟1，周 峘1，徐 华1，麻 静1, 2   

  1. 1. 上海交通大学医学院附属仁济医院内分泌代谢科，上海200127；2. 上海交通大学中国医院发展研究院，上海 200025
  • 出版日期:2020-09-28 发布日期:2020-11-04
  • 通讯作者: 麻 静，电子信箱：cherry1996@live.cn。
  • 作者简介:蒋毅弘（1988—），女，住院医师，博士；电子信箱：jiangyihong_rj@163.com。
  • 基金资助:
    上海市教育委员会高峰高原学科建设计划（20181807）；上海市浦江人才计划资助（2019PJD027）；上海交通大学中国医院发展研究院医院管理建设项目（CHDI-2019-A-01）。

Clinical observation of gastric emptying rate in patients with diabetes

JIANG Yi-hong1, LIU Wei1, ZHOU Huan1, XU Hua1, MA Jing1, 2   

  1. 1. Department of Endocrinology and Metabolism, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai 200025, China
  • Online:2020-09-28 Published:2020-11-04
  • Supported by:
    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support (20181807); Shanghai Pujiang Program (2019PJD027); Hospital Management and Construction Project of China Hospital Development Institute, Shanghai Jiao Tong University (CHDI-2019-A-01).

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摘要： 目的·比较病程匹配的1型糖尿病（type 1 diabetes mellitus，T1DM）和2型糖尿病（type 2 diabetes mellitus，T2DM）患者的胃排空速率，探讨T1DM患者胃排空速率对餐时胰岛素方案设计的影响。方法·回顾性分析2013年9月—2014年6月上海交通大学医学院附属仁济医院内分泌代谢科收治的16例T1DM患者和病程匹配的32例T2DM患者的胃半排空时间（gastric half-emptying time，T50）和临床资料。比较病程匹配的T1DM和T2DM患者的T50和相关临床资料是否具有差异，并分析T1DM患者的T50对餐时胰岛素方案设计的影响。结果·T1DM患者的T50显著长于病程匹配的T2DM患者（P=0.013）。胃排空延迟的T1DM患者与胃排空正常的T1DM患者相比需要缩短胰岛素注射距离就餐的时间。结论·T1DM患者胃排空速率较病程匹配的T2DM患者慢。T1DM患者行胃排空检查不仅能早期发现糖尿病患者胃排空速率异常，而且对餐时胰岛素方案的选择，优化血糖控制，及避免血糖波动具有临床指导意义。

关键词: 胃排空, 糖尿病, 餐后血糖, 餐时胰岛素

Abstract:

Objective · To compare the gastric emptying rate in course-matched patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), and to explore the impact of gastric emptying rate on premeal insulin therapy design in patients with T1DM. Methods · The gastric half-emptying time (T50) and clinical data of 16 patients with T1DM and 32 course-matched patients with T2DM treated at the Department of Endocrinology and Metabolism, Renji Hospital, Shanghai Jiao Tong University School of Medicine from September 2013 to June 2014 were analyzed, retrospectively. The T50 and clinical data of the course-matched patients with T1DM and T2DM were compared. The impact of T50 on premeal insulin therapy design in patients with T1DM was analyzed. Results · The T50 of patients with T1DM was significantly longer than that of the course-matched patients with T2DM (P=0.013). T1DM patients with delayed gastric emptying rate tended to shorten the time between insulin injection and meal than those with normal gastric emptying rate. Conclusion · The gastric emptying rates of patients with T1DM are slower than those of the course-matched patients with T2DM. Measurement of gastric emptying rate not only detects abnormal gastric emptying rate in patients with diabetes but also guides the choice of premeal insulin therapy, optimizes glycemic control and avoids large glucose fluctuations in patients with TIDM.

Key words: gastric emptying, diabetes, postprandial glucose, premeal insulin

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