摘要
目的研究胆汁反流性胃炎（ＢＲＧ）患者胆囊（ＧＢ）排空功能及其与胆汁反流的关系．方法采用随机、双盲和对照的方法，应用实时超声检查研究了３２例ＢＲＧ患者和２６例健康对照者的空腹ＧＢ容量（ＦＧＶ）和餐后ＧＢ排空功能．结果ＦＧＶ（ｃｍ３，ｘ±ｓｘ）ＢＲＧ患者（２３５±１５）明显大于对照组（１９７±１３，Ｐ＜００１）．餐后１５ｍｉｎＧＢ排出量（ＧＥＦ）ＢＲＧ患者即显著减少（Ｐ＜００１），餐后４５ｍｉｎ减少达最大（４５３％ｖｓ７０３％）．最大ＧＥＦＢＲＧ患者（６５４％）明显少于对照组（８０２％，Ｐ＜００１）．ＧＢ排空速度ＢＲＧ患者显著慢于对照组（Ｐ＜００１）．结论ＢＲＧ患者ＧＢ排空明显不良，可能系ＧＢ收缩无力和（或）Ｏｄｄｉ括约肌松弛不良所致；餐后ＧＥＦ减少与ＦＧＶ增多有关，从而使消化间期排入肠道的胆汁增多。
AIM To study gallbladder (GB) emptying function and its relationship to bile reflux in patients with bile reflux gastritis (BRG). METHODS Thirty two patients with BRG and 26 normal controls were studied by using real time ultrasonography according to a randomized, double blind and controlled method. RESULTS Fasting GB volume (FGV, ±s x ,cm 3) was higher in BRG patients (23 5±1 5), compared with controls (19 7±1 3, P <0 01). GB ejection fraction (GEF) was significantly decreased 15min ( P <0 01), and more markedly 45min after meal in BRG patients (45 3%) than in controls (70 3%). The maximum GEF was significantly less (65 4% vs 80 2%, P <0 01), and the speed of GB emptying was slower in BRG patients than in controls ( P <0 01) . CONCLUSION A significantly abnormal GB emptying function in BRG patients may be induced by weak contraction of GB wall and/or dysrelaxation of Oddi sphincter. A less GB emptying after meal may be related to increased FGV, as a result,more interdigestive bile flow into the duodenum and whereafter reflux back to the stomach.
关键词
胆汁反流
胃炎
胆囊排空
胃肿瘤
bile reflux
gastritis
gallbladder emptying
stomach neoplasms
