食管粘膜阻抗在诊断胃食管反流病的意义

Value of esophageal mucosal impedance of gastroesophageal reflux disease diagnosis

胃食管反流病(GERD)是一种复杂的疾病,具有异质的症状特征和多方面的致病基础。食管粘膜阻抗是反流的标志。受损的食管粘膜完整性在引起GERD症状中起作用。测量了沿食道的粘膜阻抗的变化程度,可用于诊断GERD患者反流对食管粘膜造成的影响。使用食管多通道腔内阻抗pH实验测量食管基线阻抗被认为是检查食管粘膜完整性研究的替代技术,有助于鉴别GERD与非GERD。内镜引导下粘膜阻抗试验是一项新技术,它利用一根直视导管接触食管内壁,以确定慢性胃十二指肠内容物引起的上皮细胞变化。这个测试本质上是测量食管上皮细胞对电流的传导能力。慢性GERD患者的食管上皮细胞改变,细胞间的间隙扩大和长期处于湿润状态,导致高导电性和低粘膜阻抗。内窥镜检查指导下的粘膜阻抗和粘膜导纳的实时测量可能有助于估计粘膜完整性,并可能以类似于24 h食管多通道腔内阻抗pH监测的方式成为GERD患者的有用诊断工具。

gastroesophageal reflux disease(GERD)is a complex disease with heterogeneous symptoms and various pathogenic mechanisms.Esophageal mucosal impedance is a sign of reflux.Impaired esophageal mucosal integrity plays a role in the development of GERD symptoms.It can be used to diagnose the effect of reflux on esophageal mucosa in GERD patients.The measurement of esophageal baseline impedance using multi-channel intraluminal impedance pH test is considered to be an alternative technique for the study of esophageal mucosal integrity,which helps to differentiate GERD from Non-GERD related conditions.Endoscopic guided mucosal impedance test(EMT)is a new technique that uses an open-ended catheter to contact the inner wall of the esophagus to determine the changes in epithelial cells caused by chronic gastroduodenal contents.This test essentially measures the ability of esophageal epithelial cells to conduct electricity.In patients with chronic GERD,esophageal epithelial cell changes,enlarged intercellular space and long-term moist state lead to high electrical conductivity and low mucosal impedance.Real time measurement of mucosal impedance and mucosal admittance guided by endoscopy may help to estimate mucosal integrity and may be a useful diagnostic tool for GERD patients in a manner similar to 24-hour esophageal multichannel impedance pH monitoring.