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目的 研究胆汁反流性胃炎（ＢＲＧ） 患者胆囊（ＧＢ） 排空异常的发生机制．方法 按随机、双盲及对照的原则，用实时超声研究了３８ 例ＢＲＧ 患者和３０ 例正常对照组ＧＢ 排空功能及硝苯吡啶（Ｎｉ） 对ＧＢ 排空的影响．结果 空腹ＧＢ 容量ＢＲＧ 组明显多于对照组（ Ｐ＜ ０－０１） ，服Ｎｉ前后ＧＢ 容量无明显变化（ Ｐ＞ ０－０５） ． 餐后１５ｍｉｎ 起ＧＢ 排出量（ＧＥＦ） 即明显少于对照组（ Ｐ＜ ０－０１） ，４５ｍｉｎ 时更著． 口服Ｎｉ 后２５ｍｉｎ ＢＲＧ 组ＧＥＦ 即显著增加（ Ｐ＜ ０－０１） ，２０ ｍｇ Ｎｉ 更著；ＧＢ排空速度明显增快（ Ｐ＜ ０－０１） ；最大ＧＢ 排空时间明显缩短（ Ｐ＜ ０－０１） ． 服Ｎｉ 前后血浆促胃液素水平无明显差异（ Ｐ＞ ０－０５） ． 对照组口服Ｎｉ 后ＧＥＦ 明显减少（ Ｐ＜ ０－０１） ，２０ ｍｇ者更著．结论 Ｏｄｄｉ 括约肌松弛不良可能为ＢＲＧ 患者ＧＢ 排空异常的发生机制之一；口服Ｎｉ 有明显改善其ＧＢ 排空的作用，但对消化间期ＧＢ 排空无明显影响，Ｎｉ 改善ＧＢ 排空不依赖促胃液素．
Objective To investigate the mechanism of abnormal emptying of gallbladder (GB) in patients with bile reflux gastritis (BRG). Methods According to the principle of randomized, double-blind and control, the effect of GB evacuation and nifedipine (Ni) on GB emptying in 38 patients with BRG and 30 normal controls were studied by real-time ultrasound. Results The fasting GB volume in BRG group was significantly higher than that in control group (P <0-01). There was no significant change in GB volume before and after serving Ni (P> 0-05). From 15min after meal, the amount of GBE (GEF) was significantly less than that of the control group (P <0-01), even more at 45min. GEF in BRG group increased significantly (P <0-01) at 25 min after oral administration of Ni and more at 20 mg Ni; GB evacuation rate increased significantly (P <0-01); maximal GB evacuation time significantly shortened (P <0 -01). There was no significant difference in plasma gastrin levels before and after serving Ni (P> 0-05). The control group after oral administration of Ni significantly decreased GEF (P <0-01), 20 mg even more. Conclusions Oddi sphincter muscle relaxation may be one of the mechanisms of abnormal GB emptying in patients with BRG. Oral administration of Ni significantly improves the GB emptying effect, but has no obvious effect on the GB emptying in the interdigestive period. Ni improves the GB emptying independent Gastrin.