中国合理用药探索2025，Vol.22Issue(3)：43-48,6.DOI:10.3969/j.issn.2096-3327.2025.03.008
腹腔镜袖状胃切除术联合二甲双胍治疗2型糖尿病的效果及安全性
Efficacy and Safety of Laparoscopic Sleeve Gastrectomy Combined with Metformin in Treating Type 2 Diabetes Mellitus
摘要
Abstract
Objective:To investigate the clinical efficacy and safety of laparoscopic sleeve gastrectomy(LSG)combined with metformin in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 86 patients with T2DM treated in a hospital from February 2022 to January 2023 were selected and assigned to the control group and the observation group by random number table method,with 43 patients in each group.The diet and lifestyle habits of patients in the two groups were adjusted before treatment.The control group was treated with metformin hydrochloride extended-release tablets,and the observation group was treated with LSG in addition to the treatment given in the control group.The intraoperative indicators including intraoperative blood loss and operation time,and postoperative complications were recorded in the observation group.The plasma glucose metabolism parameters[glycosylated haemoglobin(HbA1c),2-hour postprandial blood glucose(2hPG),fasting blood glucose(FBG)],insulin resistance index(HOMA-IR),blood lipid parameters[triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],serum insulin sensitivity related parameters[protein tyrosine phosphatase 1B(PTP1B),nesfatin-1(NSF-1),undercarboxylated osteocalcin(ucOC)],clinical efficacy and adverse reactions were compared between the two groups.Results:In the observation group,the mean intraoperative blood loss was(15.28±5.26)ml and the mean operation time was(85.29±8.87)min.The incidence of postoperative complications was 4.65%.After 3 months of treatment,the levels of HbA1c,2hPG,FBG,HOMA-IR,TG,TC and LDL-C were decreased in both groups(P<0.05),with the observation group showing lower levels than the control group(P<0.05).The HDL-C level was increased in both groups(P<0.05),with the observation group showing a higher level than the control group(P<0.05).The levels of PTP1B and NSF-1 were decreased in both groups(P<0.05),with the observed group showing lower levels than the control group(P<0.05).The ucOC level was increased in both groups(P<0.05),with the observation group showing a higher level than the control group(P<0.05).The total effective rate in the observation group(93.02%)was higher than that in the control group(74.42%,P<0.05).No statistically significant difference in the total incidence of adverse reactions was observed between the two groups(P>0.05).Conclusion:LSG combined with metformin shows better clinical efficacy in the treatment of patients with T2DM,effectively improving glucose and lipid metabolism and serum levels of PTP1B,NSF-1 and ucOC,without increasing the risk of adverse reactions.关键词
二甲双胍/腹腔镜袖状胃切除术/2型糖尿病/疗效/安全性Key words
metformin/laparoscopic sleeve gastrectomy/type 2 diabetes mellitus/efficacy/safety分类
医药卫生引用本文复制引用
刘岩,胡扬喜,董星..腹腔镜袖状胃切除术联合二甲双胍治疗2型糖尿病的效果及安全性[J].中国合理用药探索,2025,22(3):43-48,6.基金项目
河南省医学科技攻关计划项目(LHGJ20210242) （LHGJ20210242）
