摘要
探讨多指标诊断胆汁反流性胃炎的临床价值。５９例慢性胃炎患者按胆汁反流程度分为非反流性胃炎组和１～３级反流性胃炎组，１０名健康志愿者为对照组。测定胃液胆汁酸浓度（ＧＣ，μｇ／ｍｌ）和ｐＨ值，胃粘膜病理积分（ＲＦＩ）和组织学Ｈｐ检出率。胃γ闪烁扫描作为诊断胆汁反流金标准。随着反流程度的加重，胃液ＧＣ和ｐＨ值增高，胃炎程度加重，Ｈｐ检出率减低（上述以２～３级反流意义显著）。以ＧＣ＞５８μｇ／ｍｌ、ｐＨ≥３．０、ＲＦＩ＞９作为异常界值，则胃炎程度与胃液胆汁酸浓度和ｐＨ值呈显著正相关，与Ｈｐ的检出率呈显著负相关。胃镜下２～３级反流、胃液ＧＣ＞５８μｇ／ｍｌ和ｐＨ≥３．０、组织学ＲＦＩ＞９和Ｈｐ阴性有诊断价值，以两项或两项以上综合指标作为标准，诊断的准确性明显提高。
The study is to define the clinical value of a series of diagnostic indices for bile reflux gastritis(BRG).Fiftynine patients with chronic gastritis were divided into four groups according to the severity of bile reflux (SBR,grades 0～3). Ten healthy volunteers entered as controls.All subjects underwent gastric biopsy for helicobacter pylori(Hp)and histologic reflux indice (RFI,grades 0～15)after Dixon criterion.The fasting gastric juice was taken to monitor pH and glycocholic acids concentration(GC), 99m Tc EHIDA scintigraphy used as golden means of bile relux.Results:the data showed that GC and pH increased with SBR.Severity of gastritis(RFI>9)had a close relation with hyperchlorhydria(pH≥3 0),raised GC(>58 μ g/ml)of gastric juice,and absence of Hp.SBR grade 2,intragastric GC>58 μg/ml,pH≥3 0,histologic RFI>9,and absence of Hp are all contributive to set the diagnosis of bile reflux.A combination of more than two such indices is recommended to diagnose BRG.
出处
《中华消化内镜杂志》
1997年第5期287-290,共4页
Chinese Journal of Digestive Endoscopy
