Mouterde O, Foucaud P, Vatier J, Dupont C, Navarro J
Hôpital Robert Debré, Paris, France.
J Pediatr Gastroenterol Nutr. 1990 Apr;10(3):327-34.
The duodenogastric reflux (DGR) is a suspected cause in some esogastric pathologies in adults: esophagitis, peptic gastric ulcers, stress ulcers, ulcers secondary to drugs, gastric cancer, and gastritis. The toxic substances of the reflux are essentially bile acids, lysolecithin, and trypsin. A number of diagnostic methods have been proposed in the adult. This study suggests a diagnosis technique for DGR in the child. Fasting gastric juice was collected by gastric intubation during 1 h and three substances were measured: phospholipids as markers of biliary reflux, trypsin as a marker of pancreatic reflux, and sialic acid as a marker of the degradation of gastric mucus. The sialic acid enabled us to evaluate some of the toxicity of DGR on the stomach. The study of 49 child subjects permitted us to show the existence, in the normal child, of biliopancreatic markers in the stomach under fasting conditions through a physiological DGR; to define the norms in the child, varying according to three age groups: 0-2 months, 2-12 months, and 1-4 years (the maximum values for an age above 4 years seemed to correspond to those in the adult); and to suggest the existence of a pathological DGR in children with antral gastritis or ulcers.
十二指肠-胃反流（DGR）被怀疑是成人一些食管胃部疾病的病因：食管炎、消化性胃溃疡、应激性溃疡、药物性溃疡、胃癌和胃炎。反流的有毒物质主要是胆汁酸、溶血卵磷脂和胰蛋白酶。针对成人已经提出了许多诊断方法。本研究提出了一种儿童DGR的诊断技术。通过胃插管在1小时内收集空腹胃液，并测量三种物质：作为胆汁反流标志物的磷脂、作为胰液反流标志物的胰蛋白酶以及作为胃黏液降解标志物的唾液酸。唾液酸使我们能够评估DGR对胃的部分毒性。对49名儿童受试者的研究使我们能够证明，在正常儿童中，通过生理性DGR，空腹状态下胃内存在胆胰标志物；根据三个年龄组（0 - 2个月、2 - 12个月和1 - 4岁）确定儿童的正常范围（4岁以上年龄组的最大值似乎与成人的最大值相对应）；并提示存在胃窦炎或溃疡的儿童中存在病理性DGR。
