王雁 袁申元 张建忠 胡鸿英 肖作亮 付汉菁 万小平 朱良湘 100730 北京同仁医院消化内科(王雁、张建忠、肖作亮、万小平)，糖尿病科(袁申元、胡鸿英、付汉菁、朱良湘) 中华内科杂志 1998 0 37 8


    关键词：糖尿病；胃肠活动；肌电复合波，移行 期刊 zhnkzz 0 论 著 fur -->


    

【摘要】 目的 探讨糖尿病患者消化间期移行性复合运动(MMC)的规律。方法 应用胃十二指肠测压技术对51例Ⅱ型糖尿病患者和15名健康志愿者进行了MMC检测,测定时间为240～360分钟。结果 糖尿病患者MMCⅢ期正常者仅27.5%，明显低于对照组(73.4%,P值<0.01),其中MMCⅢ期缺失者占41.1%(对照组为13.3%,P值<0.01)。糖尿病组MMCⅢ期胃窦部收缩波幅较对照组减低(P值<0.05)。MMC各期持续时间个体差异较大,糖尿病组与对照组相比表现为Ⅱ期延长(P值<0.01)。结论 本研究提示约70%糖尿病患者在未出现消化系统症状之前已表现为MMC异常，胃十二指肠测压为糖尿病胃肠运动功能障碍、尤其是糖尿病胃轻瘫的早期诊断和治疗提供了有效的手段。

    The study of migrating motor complex intype Ⅱ diabetes Wang Yan, Yuan Shenyuan, Zhang Jianzhong, et al. Department ofGastroenterology,Tongren Hospital,Beijing 100730

    【Abstract】 Objective Toinvestigate the characteristics of migrating motor complex (MMC) indiabetic patients. Methods 51typeⅡ diabetes (NIDDM) patientsand 15 healthy volunteers were studied after an overnight fast bymeans of 6-channel computerized manometry of antroduodenal region forat least 240 min. Results Theresults showed that phase Ⅲ ofthe MMC originated in the antrum in 14/51 (27.5%) of the diabeticpatients, which was significantly decreased than that in 11/15 (73.4%)of the normal controls (P<0.01). PhaseⅢ wereabsent in 21/51 (41.1%)of the patients and in 2/15 (13.3%) of thecontrols (P<0.05).The amplitude of phaseⅢ inantrum was lower in the diabetic group than that in the control (8.1±3.5kPa vs 10.5±3.1 kPa, P<0.05). Period of phase Ⅱ wasalso prolonged in the diabetes patients than normal subjects (27.94±13.14min vs 19.93±6.09 min, P<0.01).PhaseⅡ andphaseⅢ were all absent in 6/51(11.8%) of the diabetic patients during 240 min , but it has not beenseen in the controls.There was no significant relationship betweenthese abnormalities of MMC and the diabetic duration or complications(nervous,renal, cardiovascular,etc). Conclusion Theresults of this study demonstrated that about 70% NIDDM patients hadabnormal MMC even before the clinical symptoms of gastroparesis occured, and the gastroduodenal manometry may be an useful method inthe early diagnosis and treatment of diabetic gastroparesis.

     ......