国人24h食管pH监测正常参考值初探

A Study on the Reference Values of 24-Hour Esophageal pH Monitoring in Chinese Healthy Adults

目的 :为研究胃食管反流病 (GERD) ,提供国人 2 4h食管pH监测有关指标的正常参考值。方法 :结合我院及国内外资料的有关正常人、GERD患者 2 4h食管pH监测结果分析研究。结果 :生理性反流立位较卧位多见 ;GERD时 ,卧位pH <4百分时间大于立位 ,提示夜间酸反流造成食管粘膜酸暴露时间明显延长 ,促发炎性损伤。结论 :综合 2 3 3例国人正常参考值 (及 95 %可信区间上限 ) ,pH <4总百分时间 ( % ) 1.14± 0 .95 ( 2 .70 ) ,其立位值大于卧位 1.3 6± 1.17( 3 .2 8)、0 .69± 0 .97( 2 .2 9) ;pH <4反流次数 (次 ) 17.85± 11.5 1( 3 6.78) ;反流持续≥ 5min次数 (次 )0 .3 2± 0 .3 5 ( 0 .90 ) ;最长反流持续时间 (min) 4 .4 2± 4 .0 7( 11.12 ) ;总积分 6.0 8± 3 .5 4 ( 11.90 )。

Objective:To measure the reference values of 24 hour esophageal pH monitoring in Chinese healthy adults for the research of gastroesophageal reflux diseases (GERD). Methods: Our report and the literatures at home and abroad about 24 hour esophageal monitoring were reviewed. Results: Physical reflux was more often in upright position than in supine position. For the patients with GERD, supine fraction time pH<4 was higher than upright one, which might indicate that night reflux induced longer esophageal acid exposure and esophageal mucosal inflammation. Conclusion: The reference values of 24 hour esophageal monitoring in 233 cases of Chinese healthy adults (and the upper limit of 95% confidence interval ±1.64s)are:1.total fraction time pH<4 (%) 1.14±0.95(2.70), upright and supine fraction time pH<4 (%) 1.36±1.17(3.28) and 0.69±0.97(2.29)respectively;2. pH<4 number of reflux episodes (times) 17.85±11.51(36.78);3.number of reflux episodes >5 min (times) 0.32±0.35(0.90);4.the longest reflux episodes (min) 4.42±4.30(11.12); and 5.composite score 6.08±3.54(11.90).The levels of above parameters are significantly higher in 85 patients with GERD those that in the normal.