论文部分内容阅读
目的探讨代谢手术(metabolic surgery)对肥胖合并2型糖尿病患者血管舒张功能(vascular dilation)的影响及发生机制。方法 105例健康成人作为正常组,将31例肥胖合并2型糖尿病患者中11例未手术患者作为非手术组,20例代谢手术后患者作为代谢手术组。用高频超声检测所有观察对象安静状态下肱动脉内径(D1)、血流阻断后肱动脉内径(D2)及含服硝酸甘油后肱动脉内径(D3),计算出血流介导的血管舒张反应(flow-mediated dilation,FMD)及硝酸甘油介导的血管舒张反应(nitroglycerin-mediated dilation,NMD);测量20例代谢手术前后患者体质量、体质指数(BMI)、血压、血脂、空腹血糖、糖化血红蛋白、血清胰高血糖素样肽-1(glucagon-like peptide-1,GLP-1)及二肽基肽酶-4(dipeptidyl pepti-dase-4,DPP-4)。结果代谢手术组与非手术组相比,血管舒张功能(FMD、NMD)具有显著差异(P<0.01),与正常组血管舒张功能(FMD、NMD)相比,差异无统计学意义(P>0.05);而非手术组与正常组相比,血管舒张功能(FMD、NMD)具有显著差异(P<0.01);与代谢手术组术前相比,术后GLP-1明显升高(P<0.05),DPP-4明显降低(P<0.05)。结论肥胖合并2型糖尿病患者血管舒张功能明显低于正常人,肥胖合并2型糖尿病患者通过代谢手术治疗,体质量、BMI、血脂、血压、GLP-1、DPP-4较术前明显改善,而使血管舒张功能得到改善。
Objective To investigate the effect and mechanism of metabolic surgery on vascular dilation in obese patients with type 2 diabetes mellitus. Methods A total of 105 healthy adults were enrolled in the study. Eleven patients with obesity and type 2 diabetes were enrolled as non-operative group and 20 patients after metabolic operation as metabolic group. All patients under observation of high-frequency ultrasound brachial artery diameter (D1), brachial artery blood flow after blocking the diameter (D2) and the content of nitroglycerin after brachial artery diameter (D3) to calculate the blood flow-mediated blood vessels (FMD) and nitroglycerin-mediated dilation (NMD). The body mass, body mass index (BMI), blood pressure, blood lipid, fasting blood glucose , Glycosylated hemoglobin, serum GLP-1 and DPP-4. Results There was significant difference in the diastolic function (FMD, NMD) between the metabolic surgery group and the non-surgical group (P <0.01), and there was no significant difference between the normal group and the normal group (P> 0.05). Compared with the normal group, the non-operation group had significant difference in the diastolic function (FMD, NMD) (P <0.01). Compared with the preoperative operation, the GLP-1 level in the operation group was significantly increased (P < 0.05), DPP-4 was significantly lower (P <0.05). Conclusion The vasodilation function of obese patients with type 2 diabetes mellitus is significantly lower than that of normal people. The body mass, BMI, blood lipids, blood pressure, GLP-1 and DPP-4 in obese patients with type 2 diabetes mellitus are significantly improved compared with that before operation Vasodilation can be improved.