Samsom M, Smout A J
Department of Gastroenterology, University Hospital Utrecht, The Netherlands.
Dig Dis. 1997 Jul-Oct;15(4-5):263-74. doi: 10.1159/000171603.
It is now well recognized that the prevalence of delayed gastric emptying in both insulin-dependent as well as noninsulin-dependent diabetes mellitus is high. Recently performed studies have shown that motor disorders of several parts of the upper gastrointestinal tract contribute to this delay in gastric emptying. Traditionally, disordered motility in diabetes mellitus has been attributed to irreversible autonomic nerve damage. However, recent observations indicate that hyperglycemia causes a reversible impairment of motility in various regions of the gastrointestinal tract. Upper gastrointestinal symptoms are highly prevalent in diabetes mellitus. These dyspeptic symptoms are not only induced by delayed gastric emptying, but altered visceroperception also plays a role in the genesis of dyspeptic symptoms. There is increasing evidence that impaired gastric emptying influences glycemia control, but the clinical consequences of these observations need further investigation. At present dyspeptic symptoms form the rationale for the treatment of delayed gastric emptying with prokinetic drugs.
目前已充分认识到，胰岛素依赖型和非胰岛素依赖型糖尿病患者胃排空延迟的患病率都很高。最近进行的研究表明，上消化道多个部位的运动障碍导致了胃排空延迟。传统上，糖尿病患者的运动障碍归因于不可逆的自主神经损伤。然而，最近的观察表明，高血糖会导致胃肠道各个区域的运动功能出现可逆性损害。上消化道症状在糖尿病患者中非常普遍。这些消化不良症状不仅由胃排空延迟引起，内脏感觉改变在消化不良症状的发生中也起作用。越来越多的证据表明，胃排空受损会影响血糖控制，但这些观察结果的临床后果需要进一步研究。目前，消化不良症状是使用促动力药物治疗胃排空延迟的依据。
