同步监测酸及胆汁反流对反流性食管炎的诊断价值

Diagnostic value of simultaneously monitoring acid and bile reflux for reflux esophagitis

目的：研究反流性食管炎（ＲＥ）患者酸反流和胆汁反流的发生情况以及同时检测这两种反流的临床意义。方法：ＲＥ患者１５例及健康志愿者１２例，应用便携式ｐＨ监测仪及胆汁监测仪同步检测食管２４ｈｐＨ变化及胆汁反流情况。结果：ＲＥ组食管酸暴露时间比对照组显著增加，而ｐＨ＞８总时间百分比与对照组相似。食管胆汁反流用胆红素吸收值≥０．１４的时间百分比表示，ＲＥ组较对照组明显增高。６６．７％的ＲＥ患者存在酸及胆汁混合反流。结论：胆汁反流与酸反流同样常见于ＲＥ患者，在胃食管反流病的发生中起一定作用。

Objective: To study the incidence of acid and bile reflux in patients with reflux esophagitis(RE) and to evaluate the significance of detecting bile reflux in diagnosing RE. Methods: Using ambulatory 24 h pH monitoring and bilirubin monitoring technique, we simultaneously assessed the changes of intraesophageal pH and bile reflux during 24 h in 27 subjects (including 12 healthy volunteers and 15 patients with RE). Results: The time of esophageal acid exposure (pH<4) for RE patients was significantly greater than that for controls. But total percentage time of pH>8 in two groups was similar and both were very low. Bile reflux, represented by total percentage time of bilirubin absorbance≥0.14, was greater for patients with RE than that for controls. 66.7% of patients with RE simultaneously had acid and bile reflux. Conclusion: Both bile reflux and acid reflux are very common in patients with RE and both may play a role in the development of RE. Simultaneously monitoring acid and bile reflux is very important to diagnose RE.