Primary Duodenogastric Reflux In Patients With Egg Changes And Ghrelin Expression In Gastric Mucosa

Objective Through the analysis of electrogastrogram(EGG) and the expression of ghrelin in gastric mucosa of patients with primary duodenogastric reflux,preliminary study of the pathogenesis,gastric mucosal histology and the relationship between them and severity of bile reflux.Methods 96 patients with primary duodenogastric reflux and 30 control subjects (undergone negative endoscopy) selected randomly were given to detect electrogastrogram and the expression of ghrelin in biopsy specimens from the gastric mucosa by immunohistochemistry.Results 1.The gastric electrical activity parameter of patients with primary duodenogastric reflux compared with that of control subjects:dominant frequency and dominant power reduced significantly(P＜0.05);Normal(N%) reduced significantly(P＜0.05);Bradygastria(B%) and Tachygastria(T%) increased significantly(P＜0.05).2.The parameter of high reflux group compared with that of low reflux group:dominant frequency and dominant power reduced significantly(P＜0.05); B%of postprandial increased significantly(P＜0.05).3.The frequency of atrophy and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that in low reflux group(P＜0.05).4.The positive rate of Hp infection in high reflux group was lower than that the positive rate of Hp infection in low reflux group(P＜0.05).5.The expression of ghrelin in the superficial gastritis group the atrophy group the intestinal metaplasia group and the atypical hyperplasia group were higher than that in the control subjects(P＜0.05).6.In the superficial gastritis group the atrophy group and the intestinal metaplasia group,the expression of ghrelin was significantly different between the Hp positive group and the Hp negative group(P＜0.05).Conclusion 1.Tested by electrogastrogram(EGG),motility disorders exist in primary duodenogastric reflux patients,which is characterized by decrease and instability of dominant frequency and dominant power.2.The severity of bile reflux is positively correlated with gastric motility disorders.3.Bile reflux is a risk for gastric mucosa injury. With the increase of bile reflux,it will increase the extent of gastric mucosa injury,and decrease the expression of ghrelin.4.Ghrelin may have protective effects on gastric mucosa.5.Bile reflux may inhibit the growth of Hp,and the infection of Hp is negatively correlated with the expression of ghrelin.