原发性胆汁反流性胃炎的临床特征

The Clinical Characteristics of Primary Bile Reflux Gastritis

目的探讨原发性胆汁反流性胃炎(PBRG)的临床特征。方法选取2015年1月至2018年1月在郑州大学附属郑州中心医院消化内科行胃镜检查诊断为PBRG的230例患者为观察组,245例非胆汁反流性慢性胃炎患者为对照组。评估两组间胃黏膜充血和糜烂、萎缩、肠化、幽门螺杆菌(Hp)感染及PGR有无差异。结果观察组与对照组的Hp感染率分别为52.2%和53.5%,差异无统计学意义(P>0.05);观察组的PGR下降率为26.1%,对照组为6.1%,观察组高于对照组,差异有统计学意义(P<0.05)。观察组胃黏膜充血和糜烂、萎缩、肠化发生率高于对照组,差异有统计学意义(P<0.05)。结论胆汁反流可刺激胃黏膜,导致胃黏膜炎症及萎缩、肠化的发生,联合检测PGR可进一步评估胃黏膜损害程度。

Objective To discuss the clinical characteristics of primary bile reflux gastritis(PBRG).Methods A total of 230 patients diagnosed as PBRG by gastroscopy in the Department of Gastroenterology of Zhengzhou Central Hospital Affiliated to Zhengzhou University From January 2015 to January 2018 were selected as observation group and 245 patients with non-bile reflux chronic gastritis as control group. The differences in gastric mucosal hyperemia, erosion, atrophy, intestinal metaplasia, helicobacter pylori(Hp) infection and pepsin Ⅰ/Ⅱ ratio(PGR) between the two groups were evaluated.Results The infection rates of Hp in the observation group and the control group were 52.2% and 53.5%, and the difference was not statistically significant(P>0.05). The decrease rate of PGR in the observation group was 26.1%, and that in the control group was 6.1%, and the difference was statistically significant(P<0.05). The incidence of gastric mucosal hyperemia, erosion, atrophy and intestinal metaplasia in the observation group was higher than that in the control group, and the difference was statistically significant(P<0.05).Conclusion Bile reflux can stimulate gastric mucosa, leading to the occurrence of gastric mucosa inflammation, atrophy and intestinal metaplasia. Combined detection of PGR can further evaluate the extent of gastric mucosal damage.