论文部分内容阅读
目的探讨原发性胆汁反流性胃炎(BRG)患者内镜下胆汁反流严重度与临床症状、幽门螺杆菌(Hp)和胃黏膜病理组织学之间的关系。方法根据内镜下胆汁反流程度将948例原发性BRG患者分为Ⅰ(291例)、Ⅱ(430例)、Ⅲ级(227例)三个胆汁反流组,进行临床症状评分、Hp和胃黏膜组织病理检测,分析胆汁反流严重度与临床症状、Hp感染及胃黏膜病理的关系。结果Ⅰ、Ⅱ和Ⅲ级组的腹胀症状评分分别为(2.03±0.96)分、(2.24±0.59)分和(2.53±0.87)分(P<0.05)。Ⅰ、Ⅱ和Ⅲ级组的Hp感染率分别为45.0%、39.8%和34.8%(P<0.05)。Hp阳性组(381例)慢性炎症的严重度、活动性、黏膜萎缩和肠腺化生均明显重于Hp阴性组(567例)(P<0.05)。结论胆汁反流可能是一个独立的致病因素,与Hp感染一起共同对胃黏膜造成损伤。
Objective To investigate the relationship between severity of endoscopic bile reflux and clinical symptoms, Helicobacter pylori (Hp) and gastric mucosal histopathology in patients with primary bile reflux gastritis (BRG). Methods 948 patients with primary BRG undergoing endoscopic biliary reflux were divided into three groups: Ⅰ (291 cases), Ⅱ (430 cases) and Ⅲ (227 cases). The clinical symptoms score, Hp And gastric mucosa histopathological examination to analyze the relationship between the severity of bile reflux and clinical symptoms, Hp infection and gastric mucosal pathology. Results The bloating symptom scores of group Ⅰ, Ⅱ and Ⅲ were (2.03 ± 0.96) points, (2.24 ± 0.59) and (2.53 ± 0.87) points respectively (P <0.05). The infection rates of Hp in group Ⅰ, Ⅱ and Ⅲ were 45.0%, 39.8% and 34.8%, respectively (P <0.05). The severity, activity, mucosal atrophy and intestinal metaplasia of Hp positive group (381 cases) were significantly higher than that of Hp negative group (567 cases) (P <0.05). Conclusion Bile reflux may be an independent pathogenic factor, together with Hp infection, cause gastric mucosal damage.