十二指肠胃反流胃肠动力机制研究  

Study on Gastrointestinal Motility Mechanism of Duodenogastric Reflux

作　　者：戴菲[1] 龚均[1] 罗金燕[1] 董蕾[1] 朱有玲[1] 王学勤[1] 

机构地区：[1]西安交通大学医学院第二附属医院消化内科,710004

出　　处：《胃肠病学》2008年第2期87-90,共4页Chinese Journal of Gastroenterology

基　　金：国家自然科学基金(30170414);卫生部临床学科重点项目(20012130);陕西省科学技术研究发展计划项目[2005K12-G1(1)]资助

摘　　要：背景:十二指肠胃反流(DGR)是一种常见的生理和病理现象,与许多疾病的发生有关。目前其发生机制尚不明确。目的:探讨DGR发生与胃窦十二指肠消化间期移行性复合运动(MMC)的关系。方法:对20名健康志愿者行24h同步胃内pH监测和胆汁监测,以及夜间长时胃窦十二指肠压力测定。结果:24h同步胃内pH监测和胆汁监测后,20名健康志愿者分为2组:DGR阴性组(D1组)(7名)和DGR阳性组(D2组)(13名)。D1组MMC周期数较D2组显著增加(P<0.05);D2组胃窦十二指肠协调收缩较D1组显著减少,十二指肠推进性蠕动减少(P均<0.05)。D1组十二指肠MMCⅢ相逆蠕动发生率显著低于D2组(P<0.05)。D2组发生MMCⅢ相逆蠕动前后10min,胃内pH值分别为1.72±0.61和3.70±0.72,差异有统计学意义(P<0.01)。夜间MMCⅡ相晚期碱反流和胆汁反流的发生率显著高于Ⅰ相、Ⅱ相早期和Ⅲ相(P均<0.05)。结论:DGR的发生与胃窦十二指肠MMC周期数、Ⅱ相晚期和Ⅲ相逆蠕动有关。Duodenogastric reflux （DGR） is a common physiological and pathological phenomenon, which is related to the development of many diseases. However, its mechanism remains unclear. Aims： To appraise the relationship between DGR and interdigestive antroduodenal migrating motor complex （MMC）. Methods： Simultaneous 24- hour intragastric pH and Bilitec monitoring, and a long duration overnight antroduodenal manometry were carried out in 20 healthy volunteers. Results： After simultaneous 24-hour intragastfic pH and Bilitec monitoring, 20 healthy volunteers were divided into two groups： DGR-negative （D1） group （n=7） and DGR-positive （D2） group （n=13）. The number of MMC was significantly increased in D1 group （P〈0.05）, whereas the antroduodenal coordinated contractions and duodenal propagated contractions were significantly decreased in D2 group （P〈0.05, respectively）. The incidence of duodenal MMC phase Ⅲ retroperistalsis in D1 group decreased markedly than that in D2 group （P〈0.05）. In D2 group, the mean values of intragastric pH 10 minutes before and after MMC phase Ⅲ retroperistalsis were 1.72±0.61 and 3.70±0.72, respectively, the difference was statistically significant （P〈0.01）. The incidences of overnight alkaline reflux and bile reflux in MMC late phase Ⅱ were significantly higher than those in phase I, early phase Ⅱ and phase m （P〈0.05, respectively）. Conclusions： The occurrence of DGR is related to the number of antroduodenal MMC, late phase Ⅱ and retroperistalsis of phase Ⅲ.

关 键 词：十二指肠胃反流 消化间期 肌电复合波 移行 蠕动 

分 类 号：R573[医药卫生—消化系统] R197.32[医药卫生—内科学]