目的    探讨腹腔镜胃肠旁路手术（LRYGB）治疗肥胖型和非肥胖型2 型糖尿病的治疗效果。 方法    对2009年3月至2011年3月首都医科大学附属北京世纪坛医院31例2 型糖尿病病人接受LRYGB治疗的临床资料进行分析，根据病人术前体重指数（BMI）分为肥胖症组及非肥胖组，分析手术前后口服糖耐量试验、胰岛素抵抗、胰岛功能指数、血脂水平以及营养指标的变化。 结果    31例均成功完成手术，无中转开放手术，术后3个月肥胖组和非肥胖组病人空腹及餐后血糖、糖化血红蛋白、胰岛素抵抗、胰岛功能指数均较术前显著好转（P＜0.05），肥胖组临床完全缓解率为77.8%，有效率为100.0%；非肥胖组临床完全缓解率为76.9%，有效率为100.0%，比较两组治疗效果差异无统计学意义。血脂水平下降明显，营养指标无明显改变，未出现严重并发症。 结论    腹腔镜下胃肠旁路术可以有效治疗肥胖型及非肥胖型2型糖尿病，近期效果明显，长期效果仍待观察。

Laparoscopic gastric bypass for the treatment of obese and non-obese patients with type 2 diabetes mellitus                LIAN Dong-bo, ZHU Bin, GONG Ke, et al. Surgery Centre of Diabetes Mellitus, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Abstract    Objective    To explore the treatment of type 2 diabetes mellitus (T2DM) by laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods    The clinical data of 31 patients with T2DM performed LRYGB between March 2009 and March 2011 in Beijing Shijitan Hospital, Capital Medical University were analyzed. All the patients were arranged into two groups (obese group and non-obese group) according to preoperative BMI. The clinical records including preoperative and postoperative oral glucose tolerance test ( OGTT ), Homa-IR, Homa-β, blood lipid and nutrition status were analyzed. Results    LRYGB procedures were successfully performed in all the 31 patients with no conversion to open surgery. At three month after operation, there were significant changes in OGTT, HbA1c, Homa-IR, Homa-β and blood lipid in both groups (P＜0. 05). In obese group, the clinical complete remission rate and the overall effective rate were 77.8% and 100% respectively. In non-obese group, those were 76.9% and 100% respectively. There was no statistical difference in the remission rate between two groups. No malnutrition, anemia or complication occurred.  Conclusion    The laparoscopic Roux-en-Y gastric bypass is an effective treatment for T2DM in both obese patients and non-obese patients. The long-term outcome still need the further observation.