摘要目的 探讨十二指肠空肠旁路术(DJB)治疗非过度肥胖型2型糖尿病(T2DM)的疗效和可行性.方法 随访并检测7例行十二指肠空肠旁路术的非过度肥胖型T2DM患者术前和术后24周内的体质量指数(BMI)、空腹血糖(FPG)、餐后2h血糖(2hPG)、空腹胰岛素(F-ins)、空腹C肽(F-CP)和糖化血红蛋白(HbA1c),结合患者所应用的降糖药物剂量的变化,分析术后24周患者T2DM转归情况.结果 接受DJB的7例T2DM患者,1例完全脱离降糖药物,FBG、2hPG和HbA1c正常;5例应用降糖药物剂量明显减少,但尚未完全脱离药物；1例无明显改善.血糖完全缓解比例1/7,有效比例6/7,HbA1c达标比例5/7;患者术后各时间段BMI较术前均无明显变化.结论 十二指肠空肠旁路术可以降低非过度肥胖T2DM患者的血糖,其对血糖的控制不依赖于体质量的降低,机制尚未完全明确.

abstractsObjective To investigate the efficacy and feasibility of duodenojejunal bypass(DJB) on non-severe obese patients with type 2 diabetes mellitus (T2DM). Methods The body mass index (BMI),fasting plasma glucose (FPG),2h-postprandial plasma glucose (2hPG),fasting insulin (F-ins),fasting c-peptide(F-CP),glycated hemoglobin and hypoglycemic agents dose changes were tested in 7 patients with non-severe obese T2DM undergoing DJB,preoperatively and within 24 weeks after surgery during the follow-up.Data were collected and the clinical outcomes of T2DM were analyzed.Results In 7 cases of non-obese T2DM who underwent DJB,one patient was weaned off hypoglycemic agents with normal FPG,2hPG and HbA1c postoperatively.Five required significantly lower dosage.Nosignificant improvement in 1 case.Complete remission rate of hyperglycemia was 1/7,effective rate was 6/7,and effective rate of HbA1c was 5/7.No significant changes in BMI were observed between the preoperative and postoperative phases.Conclusion Plasma glucose level can be markedly reduced by duodenojejunal bypass in non-obese T2DM,independent of weight loss,and the mechanism remains unclear.