2型糖尿病合并胃食管反流病患者的临床特征及相关危险因素分析

Clinical characteristics and related risk factor analysis of patients with type 2 diabetes mellitus complicated with gastroesophageal reflux disease

目的分析2型糖尿病(type 2 diabetes mellitus,T2DM)合并胃食管反流病(gastroesophageal reflux disease,GERD)患者临床特征及相关危险因素。方法选取2013年1月至2017年12月收治的125例T2DM患者作为研究对象,比较合并GERD患者及非GERD患者的基本临床资料、血生化检查结果、症状、积分、内镜分级、食管测压、24 h食管p H值监测结果,分析T2DM合并GERD患者临床特征及相关危险因素。结果 125例T2DM患者中53例(42. 40%)合并GERD。两组患者在饮酒史、BMI、服用NSAIDs类药物、职业、病程、空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、血清胰岛素水平(SIL)、胰高血糖素(Glucagon)、烧心、反酸、嗳气典型症状的差异具有统计学意义(P <0. 05),且食管动力障碍程度、食管炎的发生率均较高。NSAIDs药物、FPG、Hb A1c、胰岛素与GERD发生具有显著相关性(P <0. 05)。结论 T2DM合并GERD与多种因素有关,积极控制血糖、慎用损伤胃食管黏膜药物对预防T2DM合并GERD的发生具有重要意义。

Objective To analyze the clinical characteristics and related risk factors of type 2 diabetes mellitus(T2DM)with gastroesophageal reflux disease(GERD)patients.Methods One hundred and twenty-five T2DM patients were choosen as the research objects from Jan.2013 to Dec.2017.Basic clinical data,blood biochemical examination results,symptoms,score,endoscopic grading,esophageal pressure measurement,and 24 hours esophageal pH monitoring results were compared in T2DM patients with and without GERD,clinical characteristics and related risk factors of T2DM patients with GERD were analyzed.Results The number of patients with GERD was 53 cases(42.40%)among the total 125 cases.Drinking,BMI,NSAIDs drugs,disease course,FPG,HbA1c,SIL,Glucagon,heart-burn,acid reflux,belching had significant differences between two groups,and the degree of esophageal dysplasia and the incidence of esophagitis were higher in T2DM with GERD patients.NSAIDs,FPG,HbA1c,insulin were significantly correlatted GERD(P<0.05).Conclusion Many factors are related to T2DM with GERD.Active glycemic management and cautious gastrointestinal mucosa injuring drugs usement have great significance to prevent T2DM with GERD.