[The role of neurohormonal regulatory factors in the violation of the motor evacuation function of the duodenum in chronic duodenal insufficiency].

AIM: To study the interaction of hormonal factors and indicators of vegetative homeostasis in violation of the motor evacuation function of the duodenum in chronic duodenal insufficiency (CDI).

MATERIALS AND

METHODS

70 patients with CDI were under observation. The average age of patients was 35.7±11.4 years, women were 32 (45.7%), men - 38 (54.3%). The control group included 31 healthy individuals [average age 39.1±12.3 years; there were 15 women (48.3%), 16 men (51.7%)]. Cardiorhythmographic examination and analysis of heart rate variability with the "Varicard 2.51" complex were used to study the ANS. To study the intramural nervous apparatus of the duodenum, a biopsy piece of its wall from the lower horizontal section was examined. Electrochemiluminescence analysis made it possible to determine the content of gastrin, insulin, cortisol, and somatostatin in the blood. To diagnose motor disorders of the gastroduodenal zone, peripheral electrogastroenterography was performed using the gastroenteromonitor GEM-01 "Gastroscan-GEM".

RESULTS

In patients with CDI, in addition to changes in the clinical and electrophysiological picture, changes in the vegetative status were revealed. This condition correlates with the following electrophysiological signs in CDI - hypomotor duodenum leads to a greater increase in the ratio Pi/Pi + 1 stomach / duodenum after food stimulation (17.43±2.46) in this group of patients (p=0.000). The study of the basal hormone content in CDI showed a significant increase in gastrin, cortisol and a decrease in insulin and somatostatin in comparison with the control group. The relationship between them and vegetative-electrophysiological indicators is revealed.

CONCLUSION

Comprehensive studies of myoelectric activity, the functional state of the autonomic nervous system and hormonal regulatory factors, followed by the analysis of multidimensional statistics data, revealed new pathophysiological patterns in duodenal motility disorders in CDI.