胆汁反流检测在胃食管反流病中的意义

目的 研究食管胆汁反流的发生情况，探讨其与酸、碱反流的关系及其对胃食管反流病（ＧＥＲＤ）的诊断意义。方法 应用便携式２４小时ｐＨ监测仪及胆汁监测仪同步检测反流性食管炎（ＲＥ）、胃切除术后者及健康志愿者共３４例的食管内２４小时ｐＨ变化及胆汁反流情况。结果 ＲＥ组食管酸暴露时间比对照组及胃手术后组均显著增加。各组间ｐＨ〉８总时间百分比结果相似，均较低。食管胆汁反流用胆红素吸收值≥０．１４的时间百分比表

The role of detecting bile reflux in the diagnosis of gastroesophageal reflux disease]

OBJECTIVE: To investigate the incidence of esophageal bile reflux and its relationship with acid or alkaline reflux and to evaluate the significance of detecting bile reflux in the diagnosis of gastroesophageal reflux disease (GERD). METHODS: Using ambulatory 24-hour pH monitoring and bilirubin monitoring technique, the changes of 24-hour intraesophageal pH and bile reflux in 34 subjects (including healthy subjects, patients with reflux esophagitis and patients after gastrectomy) were simultaneously assessed. RESULTS: The time of esophageal acid exposure for reflux esophagitis (RE) patients was significantly longer than that in the controls and the patients after gastrectomy, but there was no difference between postgastrectomized patients and healthy controls. Total percent time of pH > 8 in each group was similar and were very low. Bile reflux duodenogastroesophageal reflux (DGER)], represented by total time percentage of bilirubin absorbance >or=0.14, was greatest in postgastrectomized patients, and next in the patients with RE, but the value in both groups was significantly higher than that in the controls. There was a close association between DGER and total time percentage of pH < 4 (r = 0.75, P < 0.05) but a poor relationship (r = 0.17) with total time percentage pH > 8. 63.6% of the patients with RE had acid and bile reflux simultaneously. CONCLUSION: DGER is common in GERD and postgastrectomized patients. It can occur with acid reflux and may play a role in the development of GERD. It is very important to monitor acid and bile reflux at the same time in the diagnosis of GERD.