摘要
目的以核素判断肠胆反流为基础,分析胃蛋白酶原法诊断肠胆反流的可行性。方法胆囊切除胆道探查"T"管引流术后患者29例,排除胃癌及消化性溃疡患者。其中男性15例,女性14例,平均年龄56.8岁,平均术后时间67d(58～99d)。口服99Tcm-二乙三胺五乙酸(DTPA)2h后,取"T"管胆汁,测定放射性活度来判断有无十二指肠胆道反流,将患者分为反流组和无反流组。以ELISA法测定两组受试患者胆管胆汁中的胃蛋白酶原Ⅰ、Ⅱ(pepsinogenⅠ、Ⅱ,PGⅠ、PGⅡ)浓度并进行组间比较。结果通过口服99Tcm-DTPA判断,29例患者中有11例存在肠胆反流,阳性率为37.93%。反流组与无反流组PGⅠ的质量浓度差异无统计学意义(P>0.05)。反流组PGⅡ的质量浓度为(32.34±26.78)μg/L,明显低于无反流组[(112.50±127.09)μg/L](P<0.05)。检测PGⅡ观察肠胆反流的阳性率为27.59%。结论检测胆汁中PGⅡ法可以作为诊断十二指肠胆道反流的新方法,其可靠性稍低于口服99Tcm-DTPA后检测胆汁中放射性活度的方法。
Objective To analyze the feasibility of pepsinogen method in determination of duodenal-biliary reflux based on nuclide method. Methods Pepsinogen Ⅰ and pepsinogen Ⅱ in bile collected from ＂T＂ tube of 29 patients performed cholecystectomy and choledochotomy and ＂T＂ tube drainage were measured by enzyme linked immunosorbent assay （ELISA）.The results were compared with nuclide method. Results Duodenal-biliary reflux existed in 11 of the 29 patients detected by nuclide method.The positive rate was 37.93 %.The difference of pepsinogen Ⅰ concentrations in reflux group and non-reflux were not statistical significant （P 〉 0.05）. The concentration of pepsinogen Ⅱ in reflux group was （32.34 ± 26.78） μg/L, significantly lower than that in non-reflux group [（ 112.50 ± 127.09）μg/L ]（P 〈 0.05）.The positive rate of duodenal-biliary reflux detected by pepsinogen Ⅱ method was 27.59 %. Conclusion Although the pepsinogen Ⅱ method is less reliable than nuclide method, but it is a new approach to determine duodenal-biliary reflux.
出处
《生物医学工程与临床》
CAS
2007年第6期482-485,共4页
Biomedical Engineering and Clinical Medicine
关键词
肠胆反流
胆管色素结石
胃蛋白酶原
duodenal-biliary reflux
bile duct pigment calculus
pepsinogen
