Research On The Electrogastric Parameters And Autonomic Nervous Function In Patients With Type 2 Diabetes Mellitus Complicated With Gastroesophageal Reflux Disease

Objective: To investigate whether patients with type 2 diabetes and gastroesophageal reflux disease have characteristic gastric electrical activity and heart rate variability,and explore the role of type 2 diabetes autonomic nerve function and gastric emptying in the occurrence of gastroesophageal reflux disease.Methods: 1.Select patients from our department of endocrinology from January 2019 to May 2019,select 28 patients in type 2 diabetes group as test group1;21 patients in type 2 diabetes with gastroesophageal reflux group as test group 2;26 healthy volunteers were normal controls.All subjects included in the group had gastrointestinal endoscopy to exclude gastrointestinal organic diseases.2.Collect general clinical data and diabetes-related data of all study subjects;The three groups of subjects underwent pre-prandial and post-prandial electrocardiogram and heart rate variability examinations.3.Chi-square test is used for counting data comparison;independent sample t test is used for measuring data comparison;the single-factor analysis of variance was used to analyze the differences between the electrocardiogram indicators and the heart rate variability parameters of each group,and the two groups were compared LSD test was used;Pearson correlation was used to analyze the correlation between electrocardiogram indexes and heart rate variability parameters.Results:1.The differences in drinking history and body mass index(BMI)between trial 1 and trial 2 were statistically significant(P<0.05),but gender and smoking history were not statistically significant(P> 0.05).2.There was a statistically significant difference in the glycated hemoglobin,duration of diabetes,fasting blood glucose,and 2h postprandial blood glucose in the test 1 and test 2 groups(P <0.05).3.The comparison of the ratio of normal slow wave rhythm before meal and after meal,the ratio of premature and postprandial gastric dysrhythmia,and the ratio of premeal gastric electrical tachycardia in the three groups(P <0.05);In the pairwise comparison,the ratio of the normal slow-wave rhythm after meal in the trial 1 group was lower than that in the normal group,but the proportion of postprandial gastric tachycardia was higher than that in the normal group;The ratio of normal slow-wave rhythm after meal was lower than that of normal group,but the ratio of premature and postprandial gastrointestinal motility and the rate of premeditated gastric motility were higher than normal group;of the comparison between test 1 and test 2,test 2 The normal pre-prandial slow-wave rhythm ratio was lower than that in trial group 1,but the proportion of pre-prandial gastric motility and the proportion of pre-prandial gastric motility in trial 2 group were higher than those in trial 1 group.4.Comparison of autonomic nerve activity,high-frequency power,and low-frequency power of the three groups of patients was statistically significant(P <0.05);in the pairwise comparison between the two groups,the autonomic nerve activity,high frequency of test 1 and test 2 groups The power and low-frequency power were lower than those in the normal group;compared with the test 1 group and the test 2 group,the autonomic activity,high-frequency power indexes of the test 2 group were lower than that of the test 1 group.5.The proportion of normal slow-wave rhythm in the correlation between autonomic nerve function changes and gastric electrical rhythm disorders was positively correlated with autonomic activity,low-frequency power,and high-frequency power.Conclusion: 1.The occurrence of gastroesophageal reflux in type 1 and type 2 diabetes is related to the course of diabetes,HbAlc,FPG,2hPG,BMI and drinking history.2.Type 2 diabetes has a decrease in the proportion of normal gastric slow waves,and an increase in the proportion of hyperkinesis and bradykinetics,leading to gastric emptying disorders,which may be one of the reasons for gastroesophageal reflux.3.Type 2 diabetes mellitus with gastroesophageal reflux is more obvious than that of simple diabetes.4.Type 2 diabetes has autonomic dysfunction,which is positively correlated with disturbance of gastric electrical rhythm.