Résumé
OBJECTIVE: To study the association between superior mesenteric artery hemodynamic indexes and scores of lower gastrointestinal symptoms rating scales(LGSRS) in patients with type 2 diabetic mellitus. METHODS: Totally 142 inpatients with type 2 diabetes with average age of 58.76±12.32 yrs were enrolled, who were treated from August 2016 to March 2018. The history, gender, age,course and BMI were recorded, and fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), 2-hour postprandial blood glucose(PBG), total cholesterol(TC), triglyceride(TG), urine ACR and LGSRS were determined. Ultrasonic scanning of mesenteric artery was performed for hemodynamic indexes, including artery inner diameter(ID), peak systolic velocity(PSV), end-diastolic velocity(EDV), and resistance index(RI)at starting part,first level branch, and second level branch from root of the superior mesenteric artery(SMA).Patients were divided into 2 groups according to their LGSRS, 74 patients with LGSRS≥6 were in positive group, and 68 patients with LGSRS0.05), but the age and DD were significantly higher in positive group than in control group(P0.05). 3. There were no significant difference between positive group and control group in ID at starting part and first level branch of SMA, while ID at second level branch was significantly increased in positive group compared with control group [(3.83±0.85)mm vs.(3.53±0.90)mm, P<0.05)].4. RI at first(0.816±0.059 vs 0.842±0.063,P<0.05) and second level branch(0.813±0.076 vs 0.845±0.073, P<0.05) and PSV at first level branch[(110.89±46.89)cm/s vs(95.72±36.59)cm/s,P<0.05] were significantly high in positive group; there were no difference in other hemodynamic indexes between the groups. 5.Adjusted by age,DD,glycemic and lipidemic profile,Logistic regression showed that ID at first(RR=2.092,95%CI 1.080-4.050,P=0.029) and second level branch(RR=0.491,95%CI 0.252-0.955,P=0.36) and EDV at second level branch(RR=0.897,95%CI 0.824-0.976,P=0.012) were independent factors influencing LGSRS(P<0.05). CONCLUSION: Ultrosonic hemodynamic abnormalities in the superior mesenteric artery might be important factor in development of lower gastrointestinal tract symptoms in patients with type 2 diabetes.
Résumé
Objective To analyze the status of sleep disorders in patients with functional gastrointestinal disease (FGID) and its relation with symptom characteristics .Methods From January to December 2014 ,questionnaire was carried out in FGID patients who met the Rome Ⅲ criteria and visited the outpatient department of gastroenterology at six third-level general hospitals in Tianjin City to assess the severity of symptoms ,sleep quality (Pittsburgh sleep quality index ,PSQI) ,and psychological state (anxiety and depression) .Chi-square test and Mann-Whitney rank sum test were performed for statistical analysis .Results Among 931 patients with FGID ,651 (69 .92％ ) patients had sleep disorders and 280 (30 .08％ ) patients had no sleep disorders .Among 828 patients with functional dyspepsia (FD) ,360 (43 .48％ ) patients had sleep disorders complicated with and depression .Among 292 patients with irritable bowel syndrome (IBS ) , 138 (47 .26％ ) had sleep disorders complicated with anxiety and depression .Among 618 patients with FD complicated with sleep disorders , 70 (11 .33％ ) patients overlapped with IBS ;among 210 patients with FD ,but without sleep disorder ,11 (5 .24％ ) patients overlapped with IBS and the percentage of the former was higher than the latter ,and the difference was statistically significant (χ2 =6 .580 , P=0 .01) .The proportion of lower abdominal pain ,sheep fecal or hard stool ,laborious defecation or incomplete defecation in FGID patients without sleep disorder were 22 .14％ (62/280) ,11 .79％ (33/280) ,19 .29％ (54/280) and 27 .86％ (78/280) ,respectively ;which were lower than those of FGID patients with sleep disorders (36 .10％ (235/651) ,21 .20％ (138/651) ,32 .41％(211/651) and 44 .39％ (289/651));and the differences were statistically significant (χ2 =17 .552 ,11 .569 , 16 .566 and 22 .419;all P<0 .01) .FGID patients with sleep disorders have more severe symptoms such as lower abdominal pain , lower abdominal discomfort (non-pain ) , sheep fecal or hard stool , laborious defecation incomplete defecation , and urgency than FGID patients without sleep disorders ;and the differences were statistically significant (Z= -4 .423 ,-1 .973 ,-3 .360 ,-4 .467 ,-4 .550 and -2 .420 ;all P<0 .05) . Conclusions Sleep disorders ,anxiety and depression often coexist in patients with FGID .Sleep disorders are closely related with lower gastrointestinal symptoms in patients with FGID .