Bollschweiler Elfriede, Wolfgarten Eva, Pütz Benito, Gutschow Christian, Hölscher Arnulf H
Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany.
Digestion. 2005;71(2):65-71. doi: 10.1159/000084521. Epub 2005 Mar 16.
An increased incidence of Barrett's esophagus in cases with combined acidic and bile reflux is reported. The volunteers serving as controls in those studies were significantly younger than the patients. The aim of this study was to analyze bile reflux patterns of healthy volunteers aged comparably to patients with Barrett's esophagus.
19 older (8 f, 11 m; median age 51 years) (OV) and 20 younger (10 f, 10 m; median age 25 years) (YV) healthy volunteers without history of gastrointestinal disease or medication underwent simultaneous 24-hour pH and bile monitoring (Bilitec). All subjects consumed a special diet that did not interfere with bile measurements. Indicators for bile reflux in the stomach and esophagus: bilirubin probe absorption >0.25 in total measuring period (TM), upright position (excluding postprandial periods) (UP) and supine period (SP).
There were no differences between older and younger volunteers in pH monitoring. Comparing the periods of bilirubin exposure of the stomach, the median (lower and upper quartile) percentage of time was OV = 5.7% (1.0-15.0%) and YV = 3.5% (0.1-7.8%) respectively for TM (n.s.), OV = 3.1% (0.7-9.4%) and YV = 0.4% (0.0-7.1%) for UP (n.s.), and OV = 2.1% (0.2-16.7%) and YV = 5.9% (0.0-12.2%) respectively for SP (n.s.). In 10/19 older volunteers and in 18/20 younger volunteers, no reflux of bile into the esophagus was measured. However, 4 older volunteers presented bile reflux from 4.6 to 51% of the total measuring period in contrast to the younger group with a maximum of 1.3% of TM.
No significant differences in bile reflux into the stomach were distinguishable between younger and older healthy volunteers, but older volunteers more frequently exhibited bile reflux into the esophagus.
据报道，在伴有酸性和胆汁反流的病例中，巴雷特食管的发病率有所增加。在这些研究中作为对照的志愿者明显比患者年轻。本研究的目的是分析与巴雷特食管患者年龄相仿的健康志愿者的胆汁反流模式。
19名年龄较大的（8名女性，11名男性；中位年龄51岁）（老年志愿者，OV）和20名年龄较小的（10名女性，10名男性；中位年龄25岁）（年轻志愿者，YV）无胃肠道疾病或用药史的健康志愿者接受了同步24小时pH值和胆汁监测（Bilitec）。所有受试者食用不干扰胆汁测量的特殊饮食。胃和食管胆汁反流的指标：在总测量期（TM）、直立位（不包括餐后时段）（UP）和仰卧位（SP）时胆红素探头吸收>0.25。
老年和年轻志愿者在pH值监测方面无差异。比较胃内胆红素暴露时段，TM时的中位数（下四分位数和上四分位数）时间百分比分别为：老年志愿者=5.7%（1.0 - 15.0%），年轻志愿者=3.5%（0.1 - 7.8%）（无统计学差异）；UP时分别为：老年志愿者=3.1%（0.7 - 9.4%），年轻志愿者=0.4%（0.0 - 7.1%）（无统计学差异）；SP时分别为：老年志愿者=2.1%（0.2 - 16.7%），年轻志愿者=5.9%（0.0 - 12.2%）（无统计学差异）。在19名老年志愿者中有10名以及20名年轻志愿者中有18名未检测到胆汁反流至食管。然而，4名老年志愿者在总测量期的4.6%至51%出现胆汁反流，而年轻组最高为总测量期的1.3%。
年轻和老年健康志愿者在胆汁反流至胃方面无显著差异，但老年志愿者更频繁地出现胆汁反流至食管。
