107例非糜烂性胃食管反流病24 h pH阻抗监测特点分析

Analysis of the characteristics of 24-hour pH impedance monitoring in 107 cases of non-erosive gastroesophageal reflux disease

目的:分析非糜烂性胃食管反流病(non-erosive reflux disease,NERD)24 h pH阻抗监测(multiple channel intraluminal pH-impedance reflux monitoring,MII-pH)特点。方法:收集首次行MII-pH监测的成年NERD(胃镜检查已排除其他食管器质性疾病)患者107例,分析24 h pH阻抗监测的pH通道和阻抗通道的各主要反流指标的阳性率。结果:pH通道的阳性率为27.6%,其中De Meester积分的阳性率为27.1%,酸反流时间百分比的阳性率为12.8%。阻抗通道监测的阳性率为55.6%,其中反流总次数的阳性率为12.1%,液体酸反流和非酸反流次数相比差异有统计学意义(P <0.001),液体酸反流和气体反流次数相比差异有统计学意义(P <0.001);食团暴露时间百分比的阳性率为46.6%;症状相关性的阳性率为48.6%。MII-pH监测的总阳性率为61.7%。结论:MII-pH监测通过pH通道和阻抗通道可显著提高NERD的检出率,可为临床诊断和治疗提供一定的依据。

Objective:To analyze the characteristics of non-erosive reflux disease(NERD) 24 h pH impedance monitoring.Methods:One hundred and seven adult NERD patients who underwent 24 h pH impedance monitoring for the first time(other esophageal organic diseases had been excluded from gastroscopy) were collected,the positive rates of the main reflux indicators of the pH channel and the impedance channel of the 24 h pH impedance monitoring were analyzed.Results:The positive rate of pH channel was 27.6%,the positive rate of De Meester points was 27.1%,and the positive rate of acid reflux time percentage was 12.8%.The positive rate of impedance channel monitoring was 55.6%,the positive rate of the total number of reflux was 12.1%,the difference between the number of liquid acid reflux and non-acid reflux was statistically significant(P<0.001),and the difference between the number of liquid acid reflux and gas reflux was statistically significant(P<0.001);the positive rate of the percentage of food pellet exposure time was 46.6%;the positive rate of symptom correlation was 48.6%.The total positive rate of 24 h pH impedance monitoring was 61.7%.Conclusion:24 h pH impedance monitoring can significantly improve the detection rate of NERD through pH channel and impedance channel,which can provide a certain basis for clinical diagnosis and treatment.