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长期的2型糖尿病并非重症患者胃排空缓慢的危险因素。

Long-standing type II diabetes mellitus is not a risk factor for slow gastric emptying in critically ill patients.

作者信息

Nguyen Nam Q, Chapman Marianne, Fraser Robert J, Ritz Marc, Bryant Laura K, Butler Ross, Davidson Geoffrey, Zacharakis Betty, Holloway Richard H

机构信息

Department of Gastroenterology, Royal Adelaide Hospital, Adelaide SA, Australia.

出版信息

Intensive Care Med. 2006 Sep;32(9):1365-70. doi: 10.1007/s00134-006-0228-0. Epub 2006 Jun 29.

Abstract

OBJECTIVE

Delayed gastric emptying (GE) is common both in critical illness and in patients with diabetes mellitus (DM). The effect of DM on the incidence of slow GE in these patients is unknown. We evaluated the effect of DM on liquid GE in critically ill patients.

METHODS

Retrospective analysis of GE using a standard [13C]octanoic acid breath test in 12 type 2 DM patients compared with (a) 44 critically ill patients without DM, including (b) a subgroup of 15 age- and sex-matched patients and (c) 15 healthy volunteers. We determined the gastric emptying coefficient (GEC) and the gastric half-emptying time (t50). Mean APACHE II scores, blood glucose levels and use of morphine were similar between patient groups.

RESULTS

GE was faster in critically ill patients with DM (t50 122 +/- 11 min, GEC: 3.8 +/- 0.3) than in patients without DM (t50 168 +/- 16 min, GEC 2.8 +/- 0.1) and in age- and sex-matched controls (t50 165 +/- 13 min, GEC 2.7 +/- 0.2) and was similar to that in healthy volunteers (t50 148 +/- 13 min, GEC 3.5 +/- 0.1). The proportion of patients with slow emptying (GEC < 3.2) was greater in non-DM (all = 56%, matched = 60%) than in DM patients (25%) and healthy subjects (26%).

CONCLUSION

Long-standing type diabetes mellitus is not a risk factor for slow GE in critically ill patients.

摘要

目的

胃排空延迟在危重症患者和糖尿病患者中均很常见。糖尿病对这些患者胃排空缓慢发生率的影响尚不清楚。我们评估了糖尿病对危重症患者液体胃排空的影响。

方法

采用标准的[13C]辛酸呼气试验对12例2型糖尿病患者的胃排空情况进行回顾性分析,并与以下三组进行比较:(a)44例非糖尿病危重症患者,其中包括(b)15例年龄和性别匹配的患者亚组,以及(c)15名健康志愿者。我们测定了胃排空系数(GEC)和胃半排空时间(t50)。患者组之间的平均急性生理学与慢性健康状况评分系统II(APACHE II)评分、血糖水平和吗啡使用情况相似。

结果

糖尿病危重症患者的胃排空速度比非糖尿病患者(t50 168±16分钟,GEC 2.8±0.1)、年龄和性别匹配的对照组(t50 165±13分钟,GEC 2.7±0.2)更快,与健康志愿者(t50 148±13分钟,GEC 3.5±0.1)相似。胃排空缓慢(GEC<3.2)的患者比例在非糖尿病患者(全部=56%,匹配组=60%)中高于糖尿病患者(25%)和健康受试者(26%)。

结论

长期的2型糖尿病不是危重症患者胃排空缓慢的危险因素。

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