| 师振,宋健.袖状胃 +空肠旁路术联合治疗 2型糖尿病及对胰岛 β细胞功能、血管内皮功能、免疫细胞因子的影响[J].安徽医药,2026,30(2):321-325. |
| 袖状胃 +空肠旁路术联合治疗 2型糖尿病及对胰岛 β细胞功能、血管内皮功能、免疫细胞因子的影响 |
| Effects of sleeve stomach and jejunal bypass on the function of pancreatic β cells, vascular endothelial function and immune cytokines in T2DM patients |
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| DOI：10.3969/j.issn.1009-6469.2026.02.021 |
| 中文关键词: 糖尿病， 2型 度拉糖肽 袖状胃 空肠旁路术 胰岛 β细胞功能 血管内皮功能 免疫细胞因子 |
| 英文关键词: Diabetes mellitus,type 2 Dulaglutide Sleeve stomach Jejunal bypass Islet beta cell function Vascular endothe-lial function Immune cytokine |
| 基金项目:河南省医学科技攻关计划联合共建项目( LHGJ20220224) |
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| 中文摘要: |
| 目的研究袖状胃 +空肠旁路术联合治疗 2型糖尿病( T2DM)及对胰岛 β细胞功能、血管内皮功能、免疫细胞因子的影响。方法选择 2021年 7月至 2023年 6月于黄河三门峡医院治疗 T2DM病人 84例，依据随机数字表法分为试验组( n=42)、对照组( n=42)。对照组行度拉糖肽治疗，试验组行袖状胃 +空肠旁路术联合治疗。观察两组治疗前及治疗 12周后糖化血红蛋白(HbA1c)、空腹血糖( FPG)、餐后 2h血糖( 2 hPG)、甘油三酯( TG)、总胆固醇( TC)等糖脂指标；胰岛素抵抗指数( Homa IR)、岛 β细胞功能指数( Homa β)等胰岛 β细胞功能指标；血清一氧化氮( NO)、内皮素 -1(ET-1)、内皮型一氧化氮合酶( eNOS)等血胰管内皮功能指标；血清 CD3+CD4+CD8+、CD4+/CD8+等免疫细胞因子。不良反应。结果治疗 12周后，试验组 HbA1c［( 6.95±0.71)%比(7.64±0.79)%］、FPG［、(6.36、±0.65)mmol/L比( 7.11±0.74)mmol/L］、 2hPG［( 7.95±0.81)mmol/L比( 9.21±0.94)mmol/L］、 TG［( 1.53±0.17)mmol/L比( 1.86±0.21)mmol/L］、 TC［( 4.57±0.48)mmol/L比( 5.21±0.54)mmol/L］均小于对照组( P<0.05)；试验组 Homa IR小于对照组， Homa β大于对照组( P<0.05)；试验组血清 NO、eNOS及 CD3+、CD4+、CD4+/CD8+水平均高于对照组，血清 ET-1及 CD8+水平低于对照组( P<0.05)；治疗期间，两组均无显著不良反应发生。结论袖状胃 +空肠旁路术联合治疗 T2DM可有效控制血糖血脂水平，改善胰岛 β细胞功能，避免血管内皮功能损伤，纠正免疫细胞因子异常。 |
| 英文摘要: |
| Objective To study the effects of sleeve stomach and jejunal bypass combined therapy on Type 2 diabetes Mellitus(T2DM) and the function of pancreatic β cells, vascular endothelial function and immune cytokines.Methods A total of 84 T2DM pa-tients treated in the Sanmenxia Hospital of the Yellow River from July 2021 to June 2023 were divided into experimental group (n=42) and control group (n=42) according to random number table method. The control group was treated with Dulaglutide, and the experimen-tal group was treated with sleeve stomach and jejunal bypass. Glycosylated hemoglobin (HbA1c), Fasting blood glucose (FPG), 2 h post.meal blood glucose (2 hPG), triglyceride (TG), total cholesterol (TC) and other glycolipid indexes, insulin resistance index (Homa IR),islet beta cell function index (Homa β) and other islet beta cell function indicators, serum nitric oxide (NO), endothelin-1 (ET-1), endo-thelial nitric oxide synthase (eNOS) and other vascular endothelial function indicators, serum CD3+, CD4+, CD8+, CD4+/CD8+ and other immune cytokines, and adverse reaction were observed before and 12 weeks after treatment in the two groups.Results After 12 weeks of treatment, HbA1c [(6.95±0.71)% vs. (7.64±0.79)%], FPG [(6.36±0.65)mmol/L vs. (7.11±0.74)mmol/L], 2hPG [(7.95±0.81)mmol/L vs. (9.21±0.94)mmol/L], TG [(1.53±0.17)mmol/L vs. (1.86±0.21) mmol/L] and TC [(4.57±0.48)mmol/L vs. (5.21±0.54)mmol/L] in experi-mental group were lower than those in control group (P<0.05). Homa IR and β of experimental group were higher than those of control group (P<0.05). Serum levels of NO, eNOS, CD3+, CD4+, CD4+/CD8+ in experimental groups were higher than those in control group, but serum levels of ET-1 and CD8+ were lower than those in control group (P<0.05). During treatment, no significant adverse reactions occurred in both groups.Conclusion The combination of sleeve stomach and jejunal bypass in T2DM can effectively control blood glu-cose and lipid levels, improve the function of islet β cells, avoid vascular endothelial function injury and correct immune cytokine ab-normalities. |
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