2型糖尿病腹泻相关因素的分析.docVIP

2型糖尿病腹泻相关因素的分析 作者：袁凯萍，吴小微，陈婕?? 2型糖尿病；腹泻；IBS；肠动力；小肠吸收功能；肠菌群 ????2 (pdf)? ?? ［摘要］? 目的? 对2型糖尿病(DM)腹泻及IBS腹泻患者进行肠传输、小肠吸收功能及肠道菌群等的研究，探讨DM腹泻的病因机制。方法? 用不透X线标志物测定肠传输。通过D-木糖试验及BT-PABA了解小肠吸收功能及胰腺外分泌功能。通过大便特检研究肠道菌群。结果? 与IBS患者比较糖尿病腹泻肠传输时间延长，合并胰腺外分泌功能障碍、脂肪吸收不良，但小肠吸收功能并无障碍。肠道菌群失调不显著。结论? 继发于自主神经病变的肠动力下降及胰腺外分泌功能障碍在DM腹泻的发病机制中占重要地位。菌群失调及小肠吸收功能障碍对DM腹泻的发病意义不大。 ??? ? 2型糖尿病；腹泻；IBS；肠动力；小肠吸收功能；肠菌群 ?????? Study on involvements in type 2 diabetes patients with diarrhea ??? YUAN Kaiping,WU Xiaowei,CHEN Jie.Yijiadun Health Center,Wuhan 430035,China ??? Abstract］? Objective? To investigate colonic transit time,smallbowel absorption and intestinal microflora in type 2 diabetes and irritable bowel syndrome of diarrhea and to assess the mechanisms of diarrhea in diabetes.Methods? Radiopaque markers was used to analyze colonic transit time in cases with diarrhea in type 2 diabetes and IBS.Exocrine pancreatic function were examined in patients with DM or IBS by Dglycoxylose test and BTPABA test.Intestinal microflora of those cases were analysed by fecal specific test.Results? The colonic transit time of patients with diabetic diarrhea were delayed compared with that of IBS.The associated disorders in DM include impairment of exocrine pancreatic function,fat malabsorption whose prevalence to be greater than in IBS,although smallbowel absorption and intestinal microflora were similar in both groups.Conclusion? Several mechanisms may result in chronic diarrhea in DM.These include the intestinal motility abnormality secondary to autonomic neuropathy and impairment of exocrine pancreatic function.Intestinal malabsorption and intestinal microflora imbalance seems to be not the causes of diabetic diarrhea. ??? ［Key words］? type 2 diabetes;diarrhea;IBS;intestinal motility;smallbowel absorption;intestinal microflora ??? DM患者出现胃肠道症状较普通人群明显增加［1］，高达76%［2］，其中腹泻的发生率为8%～22%［2］，一般为慢性腹泻，临床特征为顽固性间歇性腹泻，棕黄色水样便，量较多，可伴脂肪泻，持续数天至数周［3］，可发生在任何时间，但经常发生于夜间［2］。糖尿病腹泻严重影响了DM患者的生活质量，影响血糖水平的控制，并可出现一系列并发症尤其是代谢紊乱，但其具体发病机制不明。现对39例糖尿病腹泻