【摘要】 本文报告伴胃内胆汁酸增高的非手术胃慢性胃炎67例,以属于正常胃粘膜或仅轻度浅表炎症者25例为对照,对比分析胃内总胆汁酸(TBA)增高与慢性胃炎两者之间的关系,发现 C 组、CSG 组、CAG 组与 CAG 伴中、重度肠化生11例之间的胃内 TBA 浓度有显著差异(P<0.05),与病情呈递增平行关系,以 CAG 伴肠化生者升高最突出、说明胃内 TBA 与 CSG、CAG、肠化生的发生与发展有重要致病意义;尤其与肠化生的关系更为密切。这组慢性胃炎的特点是:(1)空腹胃液 TBA 浓度增高;(2)胃镜下可见“显性胆汁返流”;(3)病理组织学有胃小凹上皮细胞增生较明显、细胞核分裂相增多与炎症细胞浸润偏轻等特点;(4)未经胃切除术,又无器质性梗阻因素;(5)上腹部痛、闷胀不适等消化不良症状明显,经吗丁啉、中药调节胃肠运动功能收效显著。为与残胃胆汁反流胃炎区别,本文倡用“原发性胆汁反流性胃炎”的命名。更多还原

【Abstract】 Intragastric total bile acid (TBA) was determined in 92 subjects who undergo gastroscopy and gastric mucosa biopsy,including three groups,25 healthy controls (group C),20 chronic superficial gastritis (group CSG) and 47 chronic atrophic gastritis (group CAG),11 cases of 47 GAG were with intestinal metaplasia (IM).All of them have no history of gastrectomy.Gastric juice was aspirated at begining during undergoing gastroscopy.67 cases was iagnosed reflux gastritis according to TBA level over normal (80—100 ug/ml) and visible duodenogastric reflux (DGR) under gastroscopy.The TBA level in group CSG (301±177ug/ml) were significantly higher than group.C(75—72 ug/ml)(P<0.05).In group CAG the TBA level was more higher(493—479 ug/ml) than group CSG (P<0.05).The 11 cases CAG with IM the TBA level (739—615 ug/ml) was higher than without IM.This results demonstrated the intragastric TBA and DGR are one of the important factors in development of CSG,GAG and IM,especially,are more important in development of GAG with IM.For this kind of reflux gastritis is a special type of chronic gastritis,it is necessary to termed “Primary Reflux Gastritis” to distinguish it from the reflux gastritis secondary to postgastrectomy.更多还原