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[目的]探讨胃pH联合胆红素监测诊断十二指肠胃反流(duodenogastric reflux DGR)的应用价值。[方法]对慢性胃炎组90例、对照组20例分别进行胃镜及组织学检查、总胆汁酸测定、核素显像、胃pH联合胆红素监测诊断DGR,并进行对比性分析。[结果]对照组DGR(+)检出情况:胃pH联合胆红素监测检出率0%(0/20),与胃镜及组织学检查30%(6/20)比较,差异有统计学意义(P<0.01),与其他检查比较差异无统计学意义(P>0.05)。慢性胃炎组DGR(+)检出情况:胃pH联合胆红素监测53.3%(48/90),与胃镜及组织学检查76.7%(69/90)比较,差异有统计学意义(P<0.01),与其他检查比较差异无统计学意义(P>0.05)。以核素显像检查作为标准,其他3种检查方法对慢性胃炎组检测DGR准确性的比较,胃镜及组织学检查62.2%,差异有统计学意义(P<0.01),总胆汁酸测定81.1%,差异有统计学意义(P<0.05),胃pH联合胆红素监测90.0%,差异无统计学意义(P>0.05)。[结论]胃pH联合胆红素监测是诊断DGR最准确的方法,值得推广应用。
[Objective] To investigate the value of gastric pH combined with bilirubin in the diagnosis of duodenogastric reflux (DLD). [Method] 90 cases of chronic gastritis group and 20 cases of control group were diagnosed by gastroscopy and histology, total bile acid determination, radionuclide imaging and gastric pH combined with bilirubin, respectively, and analyzed comparatively. [Results] The detection rate of DGR (+) in the control group was 0% (0/20) in gastric pH and bilirubin monitoring, compared with 30% (6/20) in gastroscopy and histological examination, the difference was statistically significant Significance (P <0.01), no significant difference compared with other tests (P> 0.05). The detection of DGR (+) in chronic gastritis group was 53.3% (48/90) in gastric pH combined with bilirubin and 76.7% (69/90) in gastroscopy and histological examination, the difference was statistically significant (P <0.01 ), No significant difference compared with other tests (P> 0.05). The radionuclide imaging examination as the standard, the other three kinds of examination for chronic gastritis group DGR accuracy, endoscopy and histological examination 62.2%, the difference was statistically significant (P <0.01), total bile acid determination of 81.1% , The difference was statistically significant (P <0.05), gastric pH with bilirubin monitoring 90.0%, the difference was not statistically significant (P> 0.05). [Conclusion] Gastric pH combined with bilirubin monitoring is the most accurate method to diagnose DGR. It is worth popularizing and applying.