Primary Bile Reflux Gastritis, Gastric Emptying And Gastric Mucosa Stomach, Motilin, Vasoactive Intestinal Peptide Expression

Objective To investigate the relationship among gastric emptying, the expression of motilin (MTL) and Vasoactive Intestinal Peptide (VIP) in gastric mucosa, primary bile reflux gastritis, and study the relationship between gastric mucosal histology and the severity of bile reflux.Methods Seventy-four patients with primary bile reflux gastric were divided into low reflux group (n=42) and high reflux group (n=32). A control group was composed of 28 subjects who showed no abnormalities during 24-hour gastric bilirubin monitoring with Bilitec 2000 and gastroscopic examination. The candidates were permormed gastric emptying, and measured gastric emptying, the expression of motilin and VIP in biopsy specimens was detected by immunohistochemistry and analyzed using pathology image analysis software.Results The expression levels of motilin in the high and low reflux groups were lower than that in the control group (558.93±223.63 and 787.09±252.97 vs 941.50±275.87, respectively; both P< 0.05), while the expression levels of VIP in the high and low reflux groups were higher than in the control group (1700.06±486.55 and 1241.19±359.34 vs 959.00±335.78, respectively; both P<0.01). The detection rates of metaplasia atrophy in the high and low reflux groups were higher than that in the control group (50.0% and 26.2% vs 7.1%, respectively; P<0.01 and 0.05). Patients with metaplastic atrophic gastritis had higher reflux rate than those with superficial gastritis (59.3% vs 30.5%,P< 0.05). The detection rate of H.pylori decreased with the aggravation of bile reflux (64.3% and 47.6% vs 25.0%, respectively; P<0.01 and 0.05). The high reflux group was lower than the control group in the rates of gastric emptying (F=5.83,q=4.82, P<0.01). The expression levels of motilin and gastric emptying rates in the Non-metaplasia atrophy and the metaplasia atrophy gastritis group were lower than in the superficial gastritis group (F=7.89, q=5.50, q=3.50; F=4.95, q=4.07, q=3.44, P<0.05). Gastric emptying rates were positively correlated to the expression of motilin in gastric mucosa (r=0.709～0.762, P< 0.01).Conclusion The expression of motilin is decreased and VIP increased in gastric mucosa of patients with primary bile reflux gastritis, the parasecretion of motilin and VIP may play a role in the development of bile reflux gastritis. Bile reflux is one of the risk factors for gastric mucosa injury. With the increase of bile reflux, the extent of gastric mucosa injury may be increased, the expression of motilin may be decreased and VIP be increased. The decrease of gastric emptying may be concerned with the decrease of motilin, and play a part in the occurrence of bile reflux.The Bile reflux can inhibit the infection of H.pylori.