酸和胆汁反流在胃食管反流病中的作用

Acid and Bile Reflux in Children with Gastroesophageal Reflux Disease

目的探讨酸和胆汁反流在小儿胃食管反流病(GERD)中的作用及这两种反流的临床意义。方法应用便携式pH监测仪及胆汁监测仪同步监测12例GERD患儿及11例健康儿童的食管内24 h pH变化和胆汁反流情况。结果GERD组食管酸暴露时间(pH<4)较对照组显著增加(P<0.05);食管胆汁反流采用胆红素吸收值≥0.14的时间百分比表示,GERD组较对照组明显增高(P<0.05),且85%GERD患儿存在酸和胆汁混合反流。结论胆汁反流和酸反流同样常见于GERD患儿,在小儿GERD发病中起重要作用,同步监测食管内pH及胆汁变化对小儿GERD的诊断具有重要意义。

Objective To investigate the role of acid and bile reflux in chiklren with gastroesophagcal reflux discse（GERD） and to evaluate the significance of detecting acid and bile reflux in diagnosing GERD in children.Methods Using ambulatory 24h pH monitoring and bilirubin monitoring technique ,we simultaneonsly assesed the changes of intraesophagcal pH and bile reflux in 23 subjects Gncluding 11 bealthy controls and 12 patients with GERD.Results The time of esophageal acid exposure（pH〈4） for GERD was significantly greater than that of controls（P〈0.05）.Intraesophageal bile reflux.represented by total pereentage time of bilirubin absorbance≥0.14.was greater in children with GERD than that in controls（P〈0.05）.Eighty-five percent of children with GERD simultaneously had acid and bile reflux Conclusions Both bile reflux and acid reflux are very common in children with GERD and both may play an role in the development of GERD.Simultancously monitoring intraesophageal acid and bile reflux is very inportant to diagnose GERD.