高分辨率食管测压联合食管24 h pH-阻抗监测对胃食管反流病的诊断意义

雷鸽; 刘新群; 范筱; 王学祥

doi:10.16016/j.1000-5404.201912196

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高分辨率食管测压联合食管24 h pH-阻抗监测对胃食管反流病的诊断意义

基础医学 | 更新时间：2026-01-09

- 高分辨率食管测压联合食管24 h pH-阻抗监测对胃食管反流病的诊断意义
- Diagnostic significance of high resolution esophageal manometry combined with 24-hour pH impedance monitoring for gastroesophageal reflux disease
- 第三军医大学学报 2020年42卷第11期页码：1141-1145
- 作者机构：
- 作者简介：
- 基金信息：
  
  河南省卫计委项目(2018020985)
- DOI：10.16016/j.1000-5404.201912196
  中图分类号：
- 收稿：2019-12-20，
  
  纸质出版：2020-06-15
- 稿件说明：
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雷鸽, 刘新群, 范筱, 等. 高分辨率食管测压联合食管24 h pH-阻抗监测对胃食管反流病的诊断意义[J]. 第三军医大学学报, 2020,42(11):1141-1145.

Ge LEI, Xinqun LIU, Xiao FAN, et al. Diagnostic significance of high resolution esophageal manometry combined with 24-hour pH impedance monitoring for gastroesophageal reflux disease[J]. Journal of Third Military Medical University, 2020, 42(11): 1141-1145.
雷鸽, 刘新群, 范筱, 等. 高分辨率食管测压联合食管24 h pH-阻抗监测对胃食管反流病的诊断意义[J]. 第三军医大学学报, 2020,42(11):1141-1145. DOI： 10.16016/j.1000-5404.201912196.

Ge LEI, Xinqun LIU, Xiao FAN, et al. Diagnostic significance of high resolution esophageal manometry combined with 24-hour pH impedance monitoring for gastroesophageal reflux disease[J]. Journal of Third Military Medical University, 2020, 42(11): 1141-1145. DOI： 10.16016/j.1000-5404.201912196.

摘要

Abstract

Objective

To investigate the effect of high resolution esophageal manometry combined with 24-hour esophageal multi-channel pH-impedance monitoring on baseline esophageal impedance in patients with gastroesophageal reflux disease (GERD).

Methods

A total of 150 patients with typical GERD symptoms admitted in our hospital from June 2017 to March 2019 were enrolled in this study. They were divided into reflux esophagitis group (RE

=38)

non-erosive reflux disease group (NERD

=68) and functional heartburn group (FH

=44). All subjects

underwent routine gastroscopy

24-hour esophageal pH-impedance monitoring and proton inhibitor (PPI) test. The BI values at 7

15 and 17 cm (a5 channel

a4 channel

a3 channel

a2 channel

a1 channel) above the lower esophageal sphincter were obtained respectively in the 3 groups

and the results were analyzed by SPSS22.0 statistical software.

Results

The distal contractile integral (DCI) and contractile front velocity (CFV) in the RE group and NERD group were significantly lower than those in FH group (

0.05). The BI values at the 5 channels of esophagus were obviously higher in the FH group than the NERD group and the RE group (

0.05). Receiver operating characteristic (ROC) curve analysis showed that the best cut-off value of esophageal BI of A5 channel in NERD group and FH group was 2 416 Ω

and the area under curve (AUC) was 0.92. And the sensitivity was 79.8% (95%

: 0.40~0.87)

specificity was 93.1% (95%

: 0.48~0.94)

positive predictive value was 98.3% (95%

: 0.52~0.99)

and negative predictive value was 48.2% (95%

: 0.53~0.90). The acid exposure time (AET) was significantly longer in the NERD group [9.40%(4.46%~25.70%)

]

group and the RE group [10.60%(4.71%~24.29%)

]

when compared with the FH group [1.06%(0.20%~2.16%)

0.05

]

and obvious difference was seen in the former 2 groups (

0.05). The BI values in the NERD group and the RE group were negatively correlated with AET respectively (

=-0.651

-0.542

0.05)

but no such correlation was seen in the FH group (

=-0.402

=0.240).

Conclusion

The results of high-resolution esophageal manometry combined with 24-hour multichannel pH impedance monitoring indicate that the BI value at 2 416 Ω of the distal esophagus is the best cut-off value for distinguishing NERD and FH. The degree of esophageal acid exposure is associated with the decrease of BI value of the esophagus in GERD patients.

关键词

Keywords

references

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