论文部分内容阅读
目的 探讨非溃疡性消化不良患者十二指肠胃反流 (DGR)与胃黏膜炎症改变之间的关系。方法 对 5 6例有腹痛、腹胀等症状的非溃疡性消化不良患者行胃镜检查及组织活检 ,并用便携式胆红素监测仪行 2 4h胃内胆红素监测 ,以反流总时间百分率 (% )作为评价胆汁反流严重度的主要观察指标 ,分析其与胃黏膜病变之间的关系。结果 高反流组及低反流组 (各 2 8例 )的Hp阳性率为 4 6 %(13/2 8例 )和 5 0 % (14 /2 8例 ,P >0 .0 5 )。内镜下各种病变的检出率分别为 :胃窦黏膜充血 10 0 %比71% (P <0 .0 5 )、出血点 /斑 18%比 11% (P >0 .0 5 )、糜烂 39%比 2 1% (P >0 .0 5 )、血管透见 14 %比14 % (P >0 .0 5 )、黏液湖或黏膜胆汁染色 4 6 %比 18% (P <0 .0 5 )。Hp阳性与Hp阴性组慢性炎症的严重度积分 [(1.77± 0 .80 )比 (1.0 7± 0 .75 ) ,P <0 .0 5 ]及活动性积分 [(1.4 8± 0 .85 )比 (0 .86± 0 .6 4 ) ,P <0 .0 5 ]差异有显著性。在Hp阳性组 ,胆汁反流严重度与肠化严重度相关 (r =0 .5 4 8,P <0 .0 5 )。在Hp阴性组 ,胆汁反流严重度与慢性炎症 (r =0 .4 86 ,P <0 .0 5 )、萎缩 (r =0 .4 76 ,P <0 .0 5 )及肠化 (r =0 .6 2 3,P <0 .0 1)等组织病理学改变的严重度相关。结论 非溃疡性消化不良患者不论是否存
Objective To investigate the relationship between duodenal regurgitation (DGR) and gastric mucosal inflammation in non-ulcer dyspepsia patients. Methods Fifty-six patients with non-ulcer dyspepsia who had abdominal pain, bloating and other symptoms underwent gastroscopy and biopsy, and monitored by intra-gastric bilirubin with a portable bilirubin monitor for the total reflux time (% ) As the main index to evaluate the severity of bile reflux and analyze its relationship with gastric mucosal lesions. Results The positive rate of Hp was 46% (13/2 8 cases) and 50% (14/28 cases, P> 0.05) in the high reflux group and the low reflux group (28 cases each). The detection rates of various lesions under endoscopy were as follows: the antral mucosal hyperemia was 100% to 71% (P <0.05), the bleeding spot was 18% to 11% (P> 0.05) Erosions were 39% to 21% (P> 0.05), 14% to 14% (P> 0.05) for vascular penetration, and 46% to 18% (P <0) for mucosal lake or mucosal bile staining. 0 5). The severity scores of chronic inflammation in Hp-positive and Hp-negative groups were significantly higher than those in Hp-negative group [(1.77 ± 0.80) vs (1.07 ± 0.75), P <0.05] and activity score [(1.4 8 ± 0.85) (0. 86 ± 0. 64), P <0. 05] the difference was significant. In Hp positive group, the severity of bile reflux was correlated with the severity of intestinal metaplasia (r = 0.548, P <0.05). In the Hp-negative group, the severity of bile reflux was associated with chronic inflammation (r = 0.46, P <0.05), atrophy (r = 0.766, P <0.05) = 0 .6 2 3, P <0. 01) and other histopathological changes related to the severity. Conclusions Patients with non-ulcerative dyspepsia, whether surviving or not,