关于胆汁反流性胃炎诊断标准的探讨.pdfVIP

中华清化内镜杂志1997年10月第1磕 第5期 ~7-2o 2B7，-^ i芝j 关于胆汁反流性胃炎诊断标准的探讨 曾锦章张万岱 张洪海彭武和张振书周殿元曾锦章张万岱张洪海 彭武和张振书周殿元 ／ ．’ ．3oq ，I ，一 摘 要 探讨多指标诊断胆汁反流性胃炎的临床价值。59例慢性胃炎患者按胆汁反 流程度分为非反流性胃炎组和l～3级反流性胃炎组，10g健康志愿者为对照组。测定胃液 胆汁酸浓度(GC，~g／m1)和pH值，胃粘膜病理积分(RFI)卸组织学Hp检出率。胃7闪烁 扫描作为诊断胆汁反流金标准。随着反流程度的加重，胃液GC和pH值增高，胃炎程度 加重，Hp检出率减低(上述以2～3缎反流意义显著)。以GC58 vg／rnl、pH≥3．0、RFI 9作为异常界值， 胃炎程度与胃液胆汁酸浓度和pH值呈显著正相关，与Hp的检出率呈 显著负相关。胃镜下2～3级反流、胃蘸GC~58／tg／ml和pH≥3．0、组织学RFI9和Hp 阴性有诊断价值，以两项或两项 上综奇指标作为标准，诊断的准确性明显提高。 关键词 胆汁反流 慢一 胃炎 7闪烁照相 ·-———— 一 一 ，。__一 ～ … —一 ／、 A STUDY 0N DIAGN0STIC CRITERIA 0F BILE REFLUX GASTRITIS Zeng jinzhang，Zhang Wandai，Zhang Honghai，et a1．PLA institute for Digestive Disease， Nanfang Hospital，First military Medical University，Guangzhou 510515 Abstract The study is to define the clinical value of a series of diagnostic indices for bile reflux gastritis(BRG)．Fiftynine patients with chronic gastritis were divided into four groups according to the severity of bile reflux(SBR．grades O～3)．Ten healthy volunteers entered as controls．All subjects un— derwent gastric biopsy for helicobacter pylori(Hp)and histologie reflux indice(RFI．grades O～15)after Dixon criterion．The fasting gastric juice was taken to monitor pH and glycocholic acids concentration (GC)．。 Tc—EHIDA seintigraphy used as golden means of bile relux．Results：the data showed that GC and pH increased with SBR．Severity 0f gastritis(RFI9)had a close relation with hyperchl0rhydrm(pH ≥3 O)，raised GC(58 g／m1)of gastricjuice，and absence of Hp．SBR grade 2，intragastrlc GC58 ~g／ml，pH≥3．0，histologic RFI9，and absence。f Hp are all contributive to set the diagnosis 0f bile re—