比较原发性胆汁反流性胃炎（BRG）与幽门螺旋杆菌（HP）感染相关性胃炎的差异，并探索影响原发性BRG发病的危险因素。

选择宁夏人民医院2017年1月至2018年1月168例慢性胃炎患者，按是否有胆汁反流及HP感染将纳入研究对象分为2组。A组为内镜诊断为BRG伴或不伴HP感染患者67例，B组为有明确的HP感染的慢性胃炎但无胆汁反流患者101例。对2组人口统计学数据、合并疾病、上消化道受累模式及病理学特征进行统计学分析。

A组患者年龄在61~70岁的发病人数最多，与B组比较，差异有统计学意义（P=0.033），2组患者发病年龄整体比较，差异无统计学意义（P>0.05）。A组男女比例接近1: 2，而B组男女比例为2: 1，差异有统计学意义（P<0.05）。2组胃炎患者最常见的症状均为上腹部疼痛或不适（A组为71.64%，B组为73.63%），差异无统计学意义（P=0.871）；A组患者次最常见的症状是反酸和胃灼热（40.29%），与B组（15.84%）比较，差异有统计学意义（P=0.000）。发现糖尿病、高血压、胆囊切除在A组患者的检出率均较B组明显高；体重过轻在A组患者中更常见，超重在B组患者中更常见，2组患者BMI值比较，差异无统计学意义（P=0.097）；而反流性食管炎在A组患者中的检出率明显高于B组，差异有统计学意义（P=0.028）；对于溃疡性疾病（胃溃疡、十二指肠溃疡），则在B组中的检出率更高，差异有统计学意义（P=0.001）；病理显示化生性萎缩在A组患者中更常见，而非化生性为萎缩则在B组中更常见，但差异无统计学意义（P>0.05）。

原发性BRG与HP感染相关性胃炎相比较，有相似之处，但在发病年龄、临床表现、合并疾病及病理学相关表现上仍有差异。女性患有反流食管炎及糖尿病、既往有胆囊切除病史与原发性BRG的发生密切相关。

To compare the difference between primary bile reflux gastritis (BRG) and helicobacter pylori (HP) infection associated gastritis and explore the risk factors of primary BRG.

168 patients with chronic gastritis in Ningxia people's hospital from January 2017 to January 2018 were enrolled. The subjects were divided into two groups according to the presence or absence of bile reflux and HP infection. In group A, 67 patients were diagnosed with endoscopic BRG with or without HP infection, while in group B, 101 patients were diagnosed with chronic gastritis with definite HP infection but without bile reflux. Demographic data, concomitant diseases, upper gastrointestinal involvement pattern and pathological features of the two groups were statistically analyzed.

The number of patients aged from 61 to 70 in group A was the highest, and the difference was statistically significant (P=0.033) compared with group B, while the overall age of patients in group 2 was not statistically significant (P>0.05). The ratio of male and female in group A was close to 1: 2, while that in group B was 2: 1, and the difference was statistically significant (P<0.05). The most common symptoms of gastritis in the two groups were upper abdominal pain or discomfort (71.64% in group A and 73.63% in group B), with no statistically significant difference (P=0.871). The second most common symptom in group A was acid regurgitation and heartburn (40.29%), with statistically significant differences (P=0.000). The detection rates of diabetes, hypertension and cholecystectomy in group A were significantly higher than those in group B. Underweight was more common in group A patients, and overweight was more common in group B patients, but there was no significant difference in BMI between the two groups (P=0.097). The detection rate of reflux esophagitis in group A was significantly higher than that in group B, and the difference was statistically significant (P=0.028). For ulcerative diseases (gastric ulcer, duodenal ulcer), the detection rate was higher in group B, with statistical significance (P=0.001). Histopathology showed that the atrophy of metaplasia was more common in group A, while the atrophy of non-metaplasia was more common in group B, but the difference was not statistically significant.

There are similarities between primary BRG and HP infection-related gastritis, but there are differences in age of onset, clinical manifestations, complications and pathologic manifestations. Women with reflux esophagitis, diabetes and a history of cholecystectomy were found to be associated with primary BRG.