摘要
目的探讨原发性胆汁反流性胃炎胃镜下胆汁反流与胃黏膜损害之间的关系。方法对218例原发性胆汁反流性胃炎患者进行胃镜检查及组织活检。分析胃镜下胆汁反流严重度与内镜所见和组织学改变之间的关系。结果根据胃镜下胆汁反流的程度将患者分成Ⅰ、Ⅱ、Ⅲ3级,各级胆汁反流组之间Hp感染率比较差异均无显著性(均P>0.05)。胃镜下不同程度胆汁反流在充血、出血、糜烂及血管透见的检出率比较差异均无显著性(均P>0.05)。Hp阳性和Hp阴性患者胃镜观察胃黏膜炎症改变在充血、出血、糜烂及血管透见检出率比较差异均无显著性(均P>0.05)。Hp阳性与Hp阴性组慢性炎症的严重度积分及活动性积分比较差异有显著性[(1.76±0.77)vs(1.16±0.79),(1.72±0.66)vs(1.06±0.59),P<0.05]。慢性炎症严重度积分及肠化和萎缩的发生率随着胃镜下胆汁反流程度的加重有逐渐增加的趋势,差异均具有显著性(P<0.05)。结论 Hp感染和胆汁反流均可造成慢性胃炎的发生。随着胆汁反流的增加,尽管在内镜下表现无明显差别,但萎缩及肠化的发生率增高,提示活检的重要性。
[Objective] To investigate the relationship between duodenogastric reflux （DGR） and pathology of gastric mucosa in the patients with primary bile reflux gastritis.[Methods] Endoscopy and histologic examination analysis were performed in 218 patients with primary bile reflux gastritis.[Results] The patients were divided into three groups,group Ⅰ （the low bile reflux group,61 patients）,group Ⅱ （the moderate bile reflux group,91 patients） and group Ⅲ （the high bile reflux group,64 patients）,based on the severity of bile reflux indicated by gastroscopy.The frequency of helicobacter pylori （H.pylori） infection and topographic abnormalities of the antral mucosal detected by gastroscopy for hyperemia,hemorrhagic spots or macula,erosion,and penetrating blood vessel,respectively,were not statistically significantly different in different bile reflux groups （P 0.05）.The scores of chronic inflammation and active inflammation were higher in patients with H.pylori infection than that in patients without H.pylori infection （1.76±0.77） vs.（1.16±0.79）,（1.72±0.66） vs.（1.06±0.59）,P 0.05）.There was a tendency that the frequency of the antral intestinal metaplasia or antral atrophy increase with the severity bile reflux （P 0.05）.[Conclusion] Excessive bile reflux is related to chronic lesion of gastric mucosa,regardless of H.pylori infection.Although the topographic abnormalities of the antral mucosal detected by gastroscopy were not different,biopsy was very important for the tendency that the frequency of the antral intestinal metaplasia or antral atrophy increase with the severity bile reflux.
出处
《中国内镜杂志》
CSCD
北大核心
2011年第4期354-357,共4页
China Journal of Endoscopy
关键词
十二指肠胃反流
炎症
胆汁
胃黏膜
duodenogastric reflux
inflammation
bile
gastric mucosa
