胃内胆汁反流检测对原发性胆汁反流性胃炎胃黏膜损伤的诊断意义  

Diagnostic meaning of stomach bile reflux monitoring of primary bile reflux gastritis with gastric mucosal lesions

作　　者：左国文[1] 梁列新[1] 农兵[1] 周庆南[1] 张法灿[1] 

机构地区：[1]广西壮族自治区人民医院消化内科,广西南宁530021

出　　处：《临床荟萃》2006年第24期1762-1764,共3页Clinical Focus

摘　　要：目的研究胃内胆汁反流检测对原发性胆汁反流性胃炎胃黏膜损伤的诊断意义。方法通过电子胃镜检查以及24小时胃内pH和胆红素监测,将原发性胆汁反流性胃炎伴胃内病理性胆汁反流患者分为两组,即伴镜下胃黏膜糜烂组和不伴镜下胃黏膜糜烂组,比较两组胃内pH和胆红素各项指标的差异。结果胆红素监测中,伴镜下胃黏膜糜烂组与不伴镜下胃黏膜糜烂组餐时长反流次数[(1.3±0.1)次vs(0.6±0.3)次]、最长反流时间[(268.3±43.7)min vs(151.4±27.7)min]、餐时最长反流时间[(8.6±2.3)min vs(4.3±1.5)min]、餐后最长反流时间[(38.9±11.3)min vs(17±7.1)min]以及餐时胆红素吸收值>0.14总时间[(16.4±7.5)min vs(9.0±3.6)min]比较差异均有统计学意义(P<0.05);两组胃内pH各项指标比较差异均无统计学意义(P>0.05)。结论在原发性胆汁反流性胃炎中,胆汁反流可以导致胃黏膜损伤;胃内胆红素监测有助于了解胃内胆汁反流的程度、状态与胃黏膜损伤的关系。Objective To study the diagnostic meaning of stomach bile reflux monitoring of the primary bile reflux gastritis with gastric mucosal lesions. Methods By endoscopy and 24-hour gastric pH and bilirubin monitoring with Bilitec 2000,the patients of primary bile reflux gastritis with pathologic bile reflux were divided into two groups; with mucosal lesions and without mucosal lesions. Results Between the two groups there were significant differences in the time of long term of reflux in meals （1.3±0.1） times vs （0.6±0.3） times,the maximal term of reflux （268. 3± 43.7） min vs （151.4±27.7） min,the maximal term of reflux in meal （8.6±2.3） min vs （4.3±1.5） min and after meals（38.9± 11.3） min vs （17±7.1） rain and the total time of bilirubin absorption value〉0. 14 in meals（16. 4±7.5） min vs （9. 0 ± 3.6） min. The differences between all indexes of gastric pH in two groups was not significant. Conclusion In the primary bile reflux gastritis, the bile reflux could induce gastric mucosal lesions; monitoring of bile reflux conduces to find out the relativity between the degree or state of gastric bile reflux and gastric mucosal lesion.

关 键 词：胃炎 胆汁返流 胃黏膜 胆红素 

分 类 号：R573.34[医药卫生—消化系统]