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Journal of Medical Ultrasonics

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1996 - Vol.23

Vol.23 No.11

Original Article(原著)

(0789 - 0795)


Relationship Between Duodenogastric Reflux and Atrophic Changes in the Gastric Mucosa

瓜田 純久1, 栗田 俊夫1, 中谷 尚登1, 片山 雅彦1, 近藤 栄作1, 松崎 浩司1, 飯田 和成1, 西野 執1, 成木 行彦1, 大塚 幸雄1, 橋本 優子2, 山崎 和子2

Yoshihisa URITA1, Toshio KURITA1, Naoto NAKATANI1, Masahiko KATAYAMA1, Eisaku KONDO1, Hiroshi MATSUZAKI1, Kazunari IIDA1, Mamoru NISHINO1, Yukihiko NARUKI1, Sachio OTSUKA1, Yuko HASHIMOTO2, Kazuko YAMAZAKI2

1東邦大学第1内科, 2東邦大学中央検査超音波室

1First Department of Internal Medicine Toho University School of Medicine, 2Ultrasonographic Laboratory Toho University School of Medicine

キーワード : Atrophic change in the gastric mucosa, Color Doppler ultrasonography, Duodenogastric reflux, Pepsinogen

To evaluate the clinical significance of duodenogastric reflux (DGR) observed by color Doppler ultrasonography after oral administration of consomme, we studied the correlation between DGR and atrophic changes in the gastric mucosa. Sixty-one patients who had undergone dye-endoscopic examination by the 0.05% crystal violet spraying method were examined with color Doppler ultrasonography using a model SSA 270 A (Toshiba) ultrasound unit. DGR was measured for 5 minutes after oral administration of 400 ml of consomme to seated subjects who had fasted overnight. We also took blood at this time to determine levels of serum pepsinogen 1 (PG 1) and 2 (PG 2). Atrophic change in the gastric mucosa was evaluated by the position of the functional atrophic border (C-l, C-2, O-l, O-2, O-3) using dye-endoscopy with the 0.05% crystal violet spraying method. A functional atrophic border was clearly demonstrated as a line between the blue and purple zones. In addition, grade of atrophic change was represented quantitatively by serum concentrations of PG 1 and PG 2. Patients of type O-3 had DGR more frequently than did those of types O-2 and C-2. The higher the grade of intestinal metaplasia, the greater the significant increase in frequency of DGR. We conclude that DGR, a gastroduodenal motility disorder, would appear to be closely related to atrophic change in the gastric mucosa and the distribution of intestinal metaplasia of the stomach.