胆汁反流对胃内pH值的影响

目的　观察胆汁反流对胃内 pH值的影响。方法　对不同浓度胆汁和胃液的混合液及内镜下抽取的黄染和无黄染胃液 ,测定pH和胆红素吸光值 ;2 0例功能性消化不良患者同步监测2 4h胃内pH和胆红素吸光值。结果　胆汁浓度为 2 0 %时吸光值已达 0 90 0 ,而pH仍在 1 0左右 ;浓度为 60 %时pH始上升达 4以上。黄染组pH <4的病例占 80 % ,吸光值为 0 .348±0 .1 31 ,无黄染组pH <4的病例占 81 % ,吸光值为 0 .0 0 8± 0 .0 0 3,pH和吸光值之间无明显相关性。 1 2例有夜间自发性碱波者 8例同步有胆红素吸光值升高 ,8例无夜间自发性碱波者 4例有胆红素吸光值升高。结论　在一定浓度下 ,胆汁反流对胃内 pH值影响较小。

The effect of bile reflux on the intragastric pH

Objective To observe the effect of bile reflux on theintragastric pH.Methods We used ambulatory intragastric pH monitoring along with simultaneous Bilitec 2000 to measure the pH and absorbance of the mixed gastric juice diluted with bile with increasing bilirubin concentration in vitro and the yellow and clear gastric juice aspirated under endoscopy.In vivo,we studied 20 functional dispepsia patients for 24 h with simultaneous intragastric pH and bilirubin monitoring.Results In vitro dilutions,the absorbance value reached to 0.900 while the concentration was only 20%,but when the pH of the solution was more than 4,it′s concentration was already up to 60%. The mean absorbance of the yellow gastric juice(0.348±0.131) was significantly higher than that of the clear juice(0.008±0.003) (P＜0.05).The pH of 80% yellow gastric juice was less than 4, the percentage was not significantly different from the clear samples (81%) (P＞0.05). The pH showed no correlation with the absorbance in the yellow and clear groungs. Eight of the 12 patients with the spontaneous nocturnal episodes of alkalinization had simultaneous increase of absorbance, 4 of the 8 subjects with no alkalinization had increase of absorbance.Conclusion In some concentration,bile reflux affect little on the intragastric pH.