24h胃pH监测对十二指肠溃疡发病机制的再探讨

RESTUDY ON ATTACK MECHANISM OF DUODENAL ULCER BY 24HOUR INTRAGASTRIC pH MONITORING

将６１例十二指肠球部溃疡（ＤＵ）患者分成二组，青年组３４例，中老年组２７例。用ＤｉｇｉｔｒｉｐｐｅｒＭＫⅢ型ｐＨ记录仪监测患者治疗前胃内２４ｈｐＨ变化。以ｐＨ＜１、ｐＨ＜２、ｐＨ＜３的总时间百分率，平均ｐＨ和中位ｐＨ为观察指标，并判定有无十二指肠胃反流。结果显示：ｐＨ＜２和ｐＨ＜３的总时间百分率，在青年组显著高于中老年组（Ｐ＜０．０５）。十二指肠胃反流的发生率，青年组３２．４％，中老年组５１．９％。２４ｈｐＨ监测ＤＵ患者显示，高酸分泌确是ＤＵ患者的主要致病因素，其在青年ＤＵ患者中更显重要。而十二指肠胃反流可能在老年患者的发病中起重要作用。因此。

Sixty-one patients with duodenal ulcer(DU) were divided into two groups.There were 34 patients in the younger group and 27 patients in the middle-old-aged group. Digitripper MK Ⅲ recorder was used to observe the change of the intragastric 24hour pH index before the patients were treated.The total fraction time pH<1,pH<2 and pH<3,mean pH and median pH were analyed,and determined if the patients had duodenogastric reflux(DGR).DGR were observed.The results showed that total fraction time of pH<2 and pH<3 were higher in younger group than that in the middle-old-aged group(P<0.05).The incidence of DGR was 32.4% in the younger group and 51.9% in the other group.The results implied that the higher acid secreting was a main etiologic factor of DU,especially in the younger patients.But DGR was likely to be a important etiologic factor in the older patients.Thus,we should mainly use antiacid agent in younger patients, and gastroenteric motility medicine at the same time in the older patients.