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本文报告伴胃内胆汁酸增高的非手术胃慢性胃炎67例,以属于正常胃粘膜或仅轻度浅表炎症者25例为对照,对比分析胃内总胆汁酸(TBA)增高与慢性胃炎两者之间的关系,发现 C 组、CSG 组、CAG 组与 CAG 伴中、重度肠化生11例之间的胃内 TBA 浓度有显著差异(P<0.05),与病情呈递增平行关系,以 CAG 伴肠化生者升高最突出、说明胃内 TBA 与 CSG、CAG、肠化生的发生与发展有重要致病意义;尤其与肠化生的关系更为密切。这组慢性胃炎的特点是:(1)空腹胃液 TBA 浓度增高;(2)胃镜下可见“显性胆汁返流”;(3)病理组织学有胃小凹上皮细胞增生较明显、细胞核分裂相增多与炎症细胞浸润偏轻等特点;(4)未经胃切除术,又无器质性梗阻因素;(5)上腹部痛、闷胀不适等消化不良症状明显,经吗丁啉、中药调节胃肠运动功能收效显著。为与残胃胆汁反流胃炎区别,本文倡用“原发性胆汁反流性胃炎”的命名。
In this paper, 67 cases of non-surgical gastric chronic gastritis with increased bile acid in the stomach were reported. Twenty-five cases of normal gastric mucosa or mild superficial inflammation were taken as control. The levels of total bile acid (TBA) and chronic gastritis Found that there was a significant difference (P <0.05) in the intragastric TBA concentration between the C group, the CSG group, the CAG group and the moderate and severe intestinal metaplasia (P <0.05) CAG with the most prominent increase in intestinal metaplasia, indicating that the stomach TBA and CSG, CAG, intestinal metaplasia occurrence and development of important pathogenic significance; in particular, the relationship with metaplasia more closely. This group of chronic gastritis is characterized by: (1) increased fasting gastric juice TBA concentration; (2) under the endoscopy can be seen “dominant bile reflux”; (3) histopathology of gastric concave epithelial cell proliferation more obvious, mitotic phase (4) without gastrectomy, and no organic obstruction factors; (5) abdominal pain, suffocation discomfort and other symptoms of dyspepsia, by the morpholine, Chinese medicine regulation Gastrointestinal motility effect significantly. For the difference between residual gastritis and gastric residual gastritis, this article advocates the name “primary bile reflux gastritis”.