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.