摘要
目的研究食管胆汁反流的发生情况，探讨其与酸、碱反流的关系及其对胃食管反流病（ＧＥＲＤ）的诊断意义。方法应用便携式２４小时ｐＨ监测仪及胆汁监测仪同步检测反流性食管炎（ＲＥ）、胃切除术后者及健康志愿者共３４例的食管内２４小时ｐＨ变化及胆汁反流情况。结果ＲＥ组食管酸暴露时间比对照组及胃手术后组均显著增加。各组间ｐＨ＞８总时间百分比结果相似，均较低。食管胆汁反流用胆红素吸收值≥０．１４的时间百分比表示，以胃手术后组为最高，ＲＥ其次，二组均较对照组明显为高。食管胆汁反流与酸暴露时间之间密切相关（ｒ＝０．７５，Ｐ＜０．０５）。６３．６％的ＲＥ患者同时存在酸及胆汁反流。结论食管胆汁反流并不少见，可与酸反流同时存在，其在ＧＥＲＤ的发生过程中起一定作用。同步动态检测食管内ｐＨ值及胆汁对ＧＥＲＤ的诊断有重要意义。
Objective To investigate the incidence of esophageal bile reflux and its relationship with acid or alkaline reflux and to evaluate the significance of detecting bile reflux in the diagnosis of gastroesophageal reflux disease (GERD). Methods Using ambulatory 24 hour pH monitoring and bilirubin monitoring technique, the changes of 24 hour intraesophageal pH and bile reflux in 34 subjects (including healthy subjects, patients with reflux esophagitis and patients after gastrectomy) were simultaneously assessed. Results The time of esophageal acid exposure for reflux esophagitis (RE) patients was significantly longer than that in the controls and the patients after gastrectomy, but there was no difference between postgastrectomized patients and healthy controls. Total percent time of pH>8 in each group was similar and were very low. Bile reflux [duodenogastroesophageal reflux (DGER)], represented by total time percentage of bilirubin absorbance ≥0.14, was greatest in postgastrectomized patients, and next in the patients with RE, but the value in both groups was significantly higher than that in the controls. There was a close association between DGER and total time percentage of pH<4 ( r =0.75, P <0.05) but a poor relationship ( r =0.17) with total time percentage pH>8. 63.6% of the patients with RE had acid and bile reflux simultaneously. Conclusion DGER is common in GERD and postgastrectomized patients. It can occur with acid reflux and may play a role in the development of GERD. It is very important to monitor acid and bile reflux at the same time in the diagnosis of GERD.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1999年第4期242-244,共3页
Chinese Journal of Internal Medicine
关键词
胃食管反流
胆汁反流
便携式监测
诊断
Gastroesophageal reflux Bile reflux Monitoring, ambulatory
