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目的研究食管胆汁反流的发生情况，探讨其与酸、碱反流的关系及其对胃食管反流病（ＧＥＲＤ）的诊断意义。方法应用便携式２４小时ｐＨ监测仪及胆汁监测仪同步检测反流性食管炎（ＲＥ）、胃切除术后者及健康志愿者共３４例的食管内２４小时ｐＨ变化及胆汁反流情况。结果ＲＥ组食管酸暴露时间比对照组及胃手术后组均显著增加。各组间ｐＨ＞８总时间百分比结果相似，均较低。食管胆汁反流用胆红素吸收值≥０．１４的时间百分比表示，以胃手术后组为最高，ＲＥ其次，二组均较对照组明显为高。食管胆汁反流与酸暴露时间之间密切相关（ｒ＝０．７５，Ｐ＜０．０５）。６３．６％的ＲＥ患者同时存在酸及胆汁反流。结论食管胆汁反流并不少见，可与酸反流同时存在，其在ＧＥＲＤ的发生过程中起一定作用。同步动态检测食管内ｐＨ值及胆汁对ＧＥＲＤ的诊断有重要意义。
Objective To study the occurrence of esophageal bile reflux, discuss its relationship with acid and alkali reflux, and its diagnostic significance to gastroesophageal reflux disease (GERD). Methods A total of 34 patients with reflux esophagitis (RE), gastrectomy and healthy volunteers were enrolled in this study. The changes of esophageal pH and bile reflux during 24 hours were detected by portable 24-hour pH monitor and bile monitor. Results The esophageal acid exposure time in RE group was significantly higher than that in control group and gastric operation group. The results for pH> 8 total time between groups were similar, both lower. Esophageal bile reflux with bilirubin absorption value ≥ 0.14 percentage of time to stomach group after surgery was the highest, RE followed by two groups were significantly higher than the control group. Esophageal bile reflux was closely related to acid exposure time (r = 0.75, P <0.05). 63.6% of RE patients had both acid and bile reflux. Conclusions Esophageal bile reflux is not uncommon and may occur concurrently with acid reflux, which plays a role in the pathogenesis of GERD. Synchronous dynamic detection of esophageal pH and bile GERD diagnosis of great significance.