青年人生理性十二指肠胃反流的相关因素  

Physiological duodenogastric reflux in young healthy adults

作　　者：陈维顺[1] 罗虹雨[1] 朱宜人[1] 钟燎原[1] 周红兵[1] 张选均[1] 

机构地区：[1]湖南省株洲市一医院(中南大学株洲临床学院),湖南省株洲市412000

出　　处：《世界华人消化杂志》2008年第30期3451-3453,共3页World Chinese Journal of Digestology

摘　　要：目的:探讨生理性十二指肠胃反流的反流特点,反流与胃黏膜组织学改变的关系.方法:选取20名青年健康志愿者,分别接受常规胃镜检查,24h动态胃内pH和胆汁反流监测,HE染色行常规组织病理学检查以及改良Giemsa染色行幽门螺杆菌检查.结果:胃镜与胃黏膜组织检查多为正常黏膜或轻度浅表性炎症,仅2名胃镜下有胆汁反流,6名Hpylori阳性.未见溃疡、糜烂、萎缩及肠化生.胆红素监测均有不同程度的十二指肠胃反流,abs>0.14的时间百分比为12.5%±8.8%,短时间反流频率62.8±36.0次、长时间反流频率5.9±3.8次、最长反流时间53.5.0±50.3min,其中立位反流时间显著性长于卧位(P=0.017).胃内pH>4的时间百分比为13.91%±10.1%,与胃内abs>0.14的时间百分比比较无相关性.结论:正常生理条件下均存在生理性十二指肠胃反流,不同个体、不同体位其反流程度不一,但这种反流不引起胃黏膜的病理性改变,也不引起胃内pH的变化.AIM： To investigate the characteristics of physiological duodenogastric reflux （DGR） in young healthy adults, and to study the relationship between DGR and pathologically altered gastric mucosa. METHODS： Twenty healthy young volunteers received the conventional endoscopy, 24 h dynamic stomach pH and bile reflux monitoring, HE staining routine pathological examination as well as improved chromatin Giemsa line inspection for H pylori. RESULTS： Of 20 cases, two subjects had bile reflux, 6 had H pylori positive tests and the rest showed normal gastric mucosa or mild antral gastritis. No ulceration, erosions, atrophy or intestinal metaplasia were observed in all subjects （including 6 Helicobacter pylori infection） on endoscopic and histological findings. All subjects were found to have bile reflux at variable degrees （gastric bilirubin absorbance 〉0.14） and total period of bile reflux （abs〉0.14） was 12.5% ± 8.8%. Of all bile reflux events, short reflux events （〈 5 min） were 62.8 ±36.0 times, long reflux events（〉 5 min） were 5.9 ± 3.8 times, and the longest reflux duration was 53.5.0 ± 50.3 min, reflux time was significantly longer during upright phase than during supine phase （P = 0.017）. But the percentages of pH 〉 4 times （13.91% ± 10.1%） in stomach were not related to the percentages of bile reflux time. CONCLUSION： Physiological duodenogastric reflux occurs in young healthy adults. Degree or state of gastric bile reflux is individually different. However, the bile reflux doesn＇t induce gastric mucosal lesions nor affect gastric pH value.

关 键 词：十二指肠胃反流 青年人 胆汁 监测 

分 类 号：R573[医药卫生—消化系统] R758.66[医药卫生—内科学]