多通道阻抗联合24 h食管pH监测在胃食管反流病中的应用

Application of combined multichannel intraluminal impedance and 24 h esophageal pH monitoring in the diagnosis of gastroesophageal reflux disease

目的探讨多通道阻抗联合24 h pH监测在胃食管反流病(gastroesophageal reflux disease,GERD),尤其在pH(-)GERD患者中的应用价值。方法 48例GERD患者应用多通道阻抗联合24 h pH监测,根据Demeester评分分为pH(-)与pH(+),其中pH(-)GERD 30例,pH(+)GERD 18例;另相同监测健康大学生志愿者20例做正常对照组。结果 GERD组酸反流次数、卧位食团暴露时间及总食团暴露时间均高于正常对照组,差别有统计学意义(P=0.01,P=0.002,P=0.03);GERD组非酸反流次数低于正常对照组,差别有统计学意义(P=0.002)。pH(-)GERD组卧位食团暴露时间高于正常对照组(P=0.015),pH(-)GERD酸反流次数及卧位食团暴露时间均低于pH(+)GERD,差别有统计学意义(P=0.02,P=0.04)。结论多通道阻抗联合24 h pH监测能发现更多的反流事件,在GERD尤其对pH(-)GERD患者的诊断有实用意义,需进一步研究。

Objective To investigate the application of combined multichannel intraluminal impedance （MII） and 24 h esophageal pH monitoring in gastroesophageal reflux disease（GERD）,especially in pH （- ）GERD patients.Methods Forty-eight patients underwent combined MII and 24 h pH monitoring, and patients were divided into pH（- ） GERD and pH（＋ ） GERD group according to Demeester score. The normal values of 20 healthy volunteers who underwent MII and 24 h pH monitoring were served as controls.Results The acid reflux frequency,ambulatory alimentary bolus exposure time and total alimentary bolus exposure of GERD were relatively higher than those in control group respectively（P = 0.01,P =0.002,P =0.03）,the non-acid reflux frequency in GERD group were relatively lower than those in control group（P =0.002）.The ambulatory alimentary bolus exposure time of pH（- ）GERD were relatively higher than that in normal group（P =0.015）,the weak base reflux frequency of pH（- ） GERD were relatively lower than that in control group（P =0.022）.The non-acid reflux frequency and ambulatory alimentary bolus exposure time of pH（- ） GERD were relatively higher than those in pH（＋） GERD（P=0.02,P=0.04）.Conclusion Combined multichannel intraluminal impedance and 24 h esophageal pH monitoring is helpful in the diagnosis of gastroesophageal reflux disease,especially in the pH（- ） GERD patients.