目的:观察不同空腹血糖(FPG)水平2型糖尿病(T2DM)患者胃转流Roux-en-Y吻合术(RYGBP)术后血糖变化及转归情况.方法:前瞻性选取胃部疾病合并T2DM患者行胃部分或全胃切除,残胃食管近端空肠Roux-en-Y吻合术25例,根据入院时FPG水平分为3组:A组(7.0 mmol/LFPG<11.1 mmol/L),B组(11.1 mmoVL≤FPG<15.0 mmol/L),C组(FPG≥15.0 mmol/L).检测各组术前(0周)、术后1,4,8,12,24周FPG水平,评估患者术后转归情况.结果:各组术后FPG较术前均有明显下降(P<0.01),术后24周A组与C组比较,B组与C组比较,差异均有统计学意义(P<0.01);A组与B组比较,差异无统计学意义(P>0.05).所有患者RYGBP术后T2DM均有不同程度的改善,治愈率为72%,结论:从血糖改善方面评估,RYGBP对所有T2DM患者均有不同程度的改善,但FPG水平过高时控制效果较差.%Objectives To evaluate the effect of gastric bypass on patients with type 2 diabetes mellitus with different fasting blood glucose level. Methods. All patients were devided into three groups with different fasting blood glucose: Group A(7.0 mmol/L≤FPG＜11.1 mmol/L, n=7), Group B (11.1 mmol/L≤FPG＜15.0 mmol/L, n=12), Group C (FPG≥15.0 mmol/L, n=6). Patients were observed for 24 weeks after gastric bypass(GBP)surgery. Fasting blood glucose level were tested at 0, 1, 4, 8, 12, 24 weeks, and the antidiabetic medication usage was analyzed before surgery and 24 weeks after surgery. Results: All groups(A, B and C)were all markly decreased(P＜0.01). However, significant differences among the groups at 24 weeks (P＜0.01). The effect on glucose control in group B was similar to group C (P＞0.05). Conclusion: In spontaneously type 2 diabetes mellitus patients, all the groups after operation were effective in terms of glucose control. But there were have different effect. These findings suggest that the more better effect is while the fasting blood level in a lower level.
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