摘要
目的 通过对胆石症和胆囊切除术后出现胆汁反流性胃炎患者的血清胃动素 (MTL)和胆囊收缩素 (CCK)检测 ,探讨十二指肠胃反流 (DGR)的发生机制。方法 对确诊胆汁反流性胃炎的胆囊切除术后患者 (A组 ,30例 )和胆石症合并胆汁反流性胃炎患者 (B组 ,2 2例 ) ,以及对照组 (C组 ,2 0例 )即胃镜无胆汁反流现象 ,病理示慢性浅表性胃炎患者 ,分别抽血测空腹血清MTL和CCK含量。结果 A组血清CCK为 5 86pg/mL± 2 .78pg/mL ,较C组 3 80pg/mL± 1.10pg/mL有显著性升高 ,A组血清MTL为310 31pg/mL± 118 2 1pg/mL ,较C组 32 6 0 0pg/mL± 5 8 0 0pg/mL的降低无显著性差异 ,B组与C组相比CCK变化无显著性差异 ,MTL较C组有显著性降低 ,值为 2 2 8 30pg/mL± 72 2 0pg/mL。结论 DGR是胆道疾患的多见病理现象。胃运动功能障碍和幽门括约肌功能不全是病理性DGR的一个重要原因 ,胃十二指肠收缩不协调可导致DGR发生。MTL和CCK对胃排空和十二指肠运动起重要调节作用 ,胆囊切除术后和胆石症患者发生病理性DGR时存在CCK和MTL分泌不协调 。
Aim To investigate the mechanism of duodenogastric reflux by detecting the serum motilin(MTL) and cholecystokinin (CCK) in bile reflux gastritis patients with cholelithiasis and postcholecystectomy.Methods All patients were divided into three groups.Identified bile reflux gastritis patients with postcholecystectomy(Group A,30 cases),bile reflux gastritis patients with cholelithiasis (Group B,22 cases) and control group (Group C,20 cases) without bile reflux under endoscopy and just chronic superficial gastritis under pathologic examination.Serum MTL and CCK concentration were detected.Results Serum CCK concentration in Group A was significantly higher than that in group C(5.86±2.78 pg/mL vs 3.80±1.10 pg/mL).Serum MTL concentration in Group A was nonsignificantly lower compared with Group C(310.31±118.21 pg/mL vs 326.00±58.00 pg/mL).There was no significant difference of serum CCK concentration between Group B and C,but serum MTL concentration in Group B was significantly lower(228.30±72.20 pg/mL vs 326.00±58.00 pg/mL).Conclusions Duodenogastric reflux (DGR) is the common pathologic phenomenon in biliary tract diseases.Gastric motility disturbance and pyloric dysfunction are the important pathogenetic agents of pathologic DGR.Loss of coordination of gastroduodenal contractibility may induce DGR.MTL and CCK play an important regulatory role in gastric emptying and duodenal motility.The secretion imbalance,regulatory disturbance of MTL and CCK may be involved in pathologic DGR.
出处
《胃肠病学和肝病学杂志》
CAS
2002年第4期356-357,共2页
Chinese Journal of Gastroenterology and Hepatology
