胆汁反流性胃炎:发病特点、诊断与治疗

A. A. Sheptulin, O. A. Storonova, P. V. Pavlov, A. S. Tertychny, D. D. Protsenko, X. V. Feoktistova
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引用次数: 0

摘要

本文讨论了胆汁反流性胃炎的争议性术语及诱发其发生的因素。本病的发病机制主要包括两部分:一是胃、十二指肠运动紊乱,导致十二指肠胃反流;二是疏水胆汁酸和溶卵磷脂对胃黏膜保护屏障的直接破坏作用。胆汁反流性胃炎的临床表现无特异性,常与消化不良综合征相对应。食管胃十二指肠镜活检及随后的组织学检查,24小时胃ph测定,胃内容物胆红素水平监测用于本病的诊断。胆道反流性胃炎的治疗包括熊去氧胆酸、原动力学、抗酸剂、质子泵抑制剂、细胞保护剂等。鉴于胆汁反流性胃炎的许多方面的研究不足和有争议的报道,这个问题需要进一步的研究。
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Biliary refl ux gastritis: features of pathogenesis, diagnostics and treatment
The article discusses the controversial terminology of biliary refl ux gastritis and the factors predisposing to its occurrence. Pathogenesis of this disease includes 2 main components: disorders of motility of the stomach and duodenum, leading to duodeno-gastric refl ux, and direct damaging eff ect of hydrophobic bile acids and lysolecithin on the protective barrier of the stomach mucosa. Clinical picture of biliary refl ux gastritis is nonspecifi c and most often corresponds to dyspepsia syndrome. Esophagogastroduodenoscopy with biopsy and subsequent histological examination, 24-hour pH-metry of the stomach, monitoring of bilirubin level in gastric contents are used in diagnostics of this disease. Treatment of biliary refl ux gastritis includes prescription of ursodeoxycholic acid, prokinetics, antacids, proton pump inhibitors, cytoprotectors. Given the insuffi cient study and controversial coverage of many aspects of biliary refl ux gastritis, this problem requires further research.
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