目的分析胃内镜联合多通道食管腔内阻抗-p H(MⅡ-p H)监测在诊断反流性食管炎(RE)中的应用价值。方法我院胃肠功能室进行胃镜、24 h MⅡ-p H监测的220例反流性食管炎患者为观察组,同期我院体检的60例健康正常人为对照组,总结反流性食管...目的分析胃内镜联合多通道食管腔内阻抗-p H(MⅡ-p H)监测在诊断反流性食管炎(RE)中的应用价值。方法我院胃肠功能室进行胃镜、24 h MⅡ-p H监测的220例反流性食管炎患者为观察组,同期我院体检的60例健康正常人为对照组,总结反流性食管炎患者24 h MⅡ-p H临床表现,统计胃镜、24 h MⅡ-p H诊断RE阳性率。结果 24 h MⅡ-p H诊断RE阳性率高于胃镜、24 h p H-De M,胃镜+24 h MⅡ-p H诊断RE阳性率高于单纯胃镜、24 h p H-De M、24 h MⅡ-p H检查(P<0.05)。观察组立位和卧位总反流、酸反流、弱酸反流及液体反流、混合反流、气体反流中位次数均高于对照组;反流时间>5min次数、最长反流次数、总p H、立位p H、卧位p H、De M积分均高于对照组(P<0.05)。结论胃镜联合24 h MⅡ-p H监测可弥补常规胃镜诊断的不足,可明确RE患者食管反流特点及反流理化性质,对RE诊断价值较高。展开更多
目的评价24 h多通道腔内阻抗-pH监测(24 h MII-pH)在胃食管反流病(GERD)诊断中的应用价值。方法选取2016年1月—2018年6月在某院就诊的326例GERD患者作为观察组,并选取同时期健康志愿者75例作为对照组,均行24 h MII-pH监测,并记录GERD...目的评价24 h多通道腔内阻抗-pH监测(24 h MII-pH)在胃食管反流病(GERD)诊断中的应用价值。方法选取2016年1月—2018年6月在某院就诊的326例GERD患者作为观察组,并选取同时期健康志愿者75例作为对照组,均行24 h MII-pH监测,并记录GERD相关参数。比较MII-pH监测与单独pH监测对GERD的诊断情况。结果①24 h pH监测结果显示,观察组各监测指标均显著高于对照组(P<0.05);②24 h MII-pH监测结果显示,除弱碱反流次数两组无明显差异(P>0.05)外,在其他指标比较中,观察组均显著高于对照组(P<0.05);③24 h MII-pH监测GERD的阳性诊断率为87.42%,与单纯食管pH监测的44.78%比较,差异有统计学意义(P<0.05)。结论24 h MII-pH可识别反流物的运动方向、酸碱性和成分,提高GERD的检出率,具有重要的临床价值。展开更多
AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five co...AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five consecutive patients with suspectedgastroesophageal reflux disease(GERD) underwent 24-h combined MII-p HM recording and one hour radionuclide scintigraphy during the course of the MIIpH M study. Catheters with 6 impedance channels and 1 p H sensor were placed transnasally. Impedance and p H data analysis were performed automatically and manually. For impedance monitoring, reflux was defined as a retrograde 50% drop in impedance, starting distally and propagating retrogradely to at least the next two more proximal measuring channels. Reflux index(RI, percentage of the entire record that esophageal p H is < 4.0) greater than 4.2% for p HM and number of refluxes more than 50 for 24 h for MII were accepted as positive test results. At scintigraphy, 240 frames of 15 seconds duration were acquired in the supine position. Gastroesophageal reflux was defined as at least one reflux episode in the esophagus. After scintigraphic evaluation, impedance-pH recordings and scintigraphic images were evaluated together and agreement between tests were evaluated with Cohen's kappa.RESULTS Sufficient data was obtained from 60(80%) patients(34 male, 56.7%) with a mean age of 8.7 ± 3.7 years(range: 2.5-17.3 years; median: 8.5 years). Chronic cough, nausea, regurgitation and vomiting were the most frequent symptoms. The mean time for recording of MII-pH M was 22.8 ± 2.4 h(range: 16-30 h; median: 22.7 h). At least one test was positive in 57(95%) patients. According to diagnostic criteria, GERD was diagnosed in 34(57.7%), 44(73.3%), 47(78.3%) and 51(85%) patients by means of p HM, MII, GES and MII-p HM, respectively. The observed percentage agreements/κ values for GES and p HM, GES and MII, GES and MII-p HM, and MII and p HM are 48.3%/-0.118; 61.7%/-0.042; 73.3%/0.116 and 60%/0.147, respectively. There was no or slight agreement between GES and p HM alone, MII alone or MII-p HM. p H monitoring alone missed 17 patients compared to combined MII-p HM. The addition of MII to pH monitoring increased the diagnosis rate by 50%.CONCLUSION No or slight agreement was found among p H monitoring, MII monitoring, MII-pH monitoring and GES for the diagnosis of gastroesophageal reflux disease.展开更多
文摘目的分析胃内镜联合多通道食管腔内阻抗-p H(MⅡ-p H)监测在诊断反流性食管炎(RE)中的应用价值。方法我院胃肠功能室进行胃镜、24 h MⅡ-p H监测的220例反流性食管炎患者为观察组,同期我院体检的60例健康正常人为对照组,总结反流性食管炎患者24 h MⅡ-p H临床表现,统计胃镜、24 h MⅡ-p H诊断RE阳性率。结果 24 h MⅡ-p H诊断RE阳性率高于胃镜、24 h p H-De M,胃镜+24 h MⅡ-p H诊断RE阳性率高于单纯胃镜、24 h p H-De M、24 h MⅡ-p H检查(P<0.05)。观察组立位和卧位总反流、酸反流、弱酸反流及液体反流、混合反流、气体反流中位次数均高于对照组;反流时间>5min次数、最长反流次数、总p H、立位p H、卧位p H、De M积分均高于对照组(P<0.05)。结论胃镜联合24 h MⅡ-p H监测可弥补常规胃镜诊断的不足,可明确RE患者食管反流特点及反流理化性质,对RE诊断价值较高。
文摘目的评价24 h多通道腔内阻抗-pH监测(24 h MII-pH)在胃食管反流病(GERD)诊断中的应用价值。方法选取2016年1月—2018年6月在某院就诊的326例GERD患者作为观察组,并选取同时期健康志愿者75例作为对照组,均行24 h MII-pH监测,并记录GERD相关参数。比较MII-pH监测与单独pH监测对GERD的诊断情况。结果①24 h pH监测结果显示,观察组各监测指标均显著高于对照组(P<0.05);②24 h MII-pH监测结果显示,除弱碱反流次数两组无明显差异(P>0.05)外,在其他指标比较中,观察组均显著高于对照组(P<0.05);③24 h MII-pH监测GERD的阳性诊断率为87.42%,与单纯食管pH监测的44.78%比较,差异有统计学意义(P<0.05)。结论24 h MII-pH可识别反流物的运动方向、酸碱性和成分,提高GERD的检出率,具有重要的临床价值。
基金Supported by the Scientific and Technological Research Council of Turkey,No.106S191-SBAG-3439
文摘AIM To evaluate the agreement of multichannel intraluminal impedance-p H monitoring(MII-p HM) and gastroesophageal reflux scintigraphy(GES) for the diagnosis of gastroesophageal reflux disease. METHODS Seventy-five consecutive patients with suspectedgastroesophageal reflux disease(GERD) underwent 24-h combined MII-p HM recording and one hour radionuclide scintigraphy during the course of the MIIpH M study. Catheters with 6 impedance channels and 1 p H sensor were placed transnasally. Impedance and p H data analysis were performed automatically and manually. For impedance monitoring, reflux was defined as a retrograde 50% drop in impedance, starting distally and propagating retrogradely to at least the next two more proximal measuring channels. Reflux index(RI, percentage of the entire record that esophageal p H is < 4.0) greater than 4.2% for p HM and number of refluxes more than 50 for 24 h for MII were accepted as positive test results. At scintigraphy, 240 frames of 15 seconds duration were acquired in the supine position. Gastroesophageal reflux was defined as at least one reflux episode in the esophagus. After scintigraphic evaluation, impedance-pH recordings and scintigraphic images were evaluated together and agreement between tests were evaluated with Cohen's kappa.RESULTS Sufficient data was obtained from 60(80%) patients(34 male, 56.7%) with a mean age of 8.7 ± 3.7 years(range: 2.5-17.3 years; median: 8.5 years). Chronic cough, nausea, regurgitation and vomiting were the most frequent symptoms. The mean time for recording of MII-pH M was 22.8 ± 2.4 h(range: 16-30 h; median: 22.7 h). At least one test was positive in 57(95%) patients. According to diagnostic criteria, GERD was diagnosed in 34(57.7%), 44(73.3%), 47(78.3%) and 51(85%) patients by means of p HM, MII, GES and MII-p HM, respectively. The observed percentage agreements/κ values for GES and p HM, GES and MII, GES and MII-p HM, and MII and p HM are 48.3%/-0.118; 61.7%/-0.042; 73.3%/0.116 and 60%/0.147, respectively. There was no or slight agreement between GES and p HM alone, MII alone or MII-p HM. p H monitoring alone missed 17 patients compared to combined MII-p HM. The addition of MII to pH monitoring increased the diagnosis rate by 50%.CONCLUSION No or slight agreement was found among p H monitoring, MII monitoring, MII-pH monitoring and GES for the diagnosis of gastroesophageal reflux disease.
