联合食管多通道腔内阻抗-pH监测在诊断胃食管反流病中的价值  

Value of combined multichannel intralumminal impedance-pH monitoring in the diagnosis of gastroesophageal reflux disease

作　　者：肖英莲[1] 林金坤[1] 彭穗[1] 杨莉[1] 汪安江[1] 胡品津[1] 陈旻湖[1] 

机构地区：[1]中山大学附属第一医院消化科,广州510080

出　　处：《中华消化杂志》2009年第9期513-516,共4页Chinese Journal of Digestion

摘　　要：目的了解联合食管多通道腔内阻抗－pH（MII—pH）监测诊断胃食管反流病（GERD）的价值。方法纳入具有烧心症状且食管黏膜无损伤患者44例，首先行MII-pH监测，然后行14d的雷贝拉唑试验（试验结束时烧心症状完全消失定义为雷贝拉唑试验阳性）。70名健康志愿者行MIIpH监测的结果作为正常值进行参照。结果根据食管pH监测存在异常食管酸暴露或酸反流症状指数（SI）阳性者20例（45．4％）。MIIpH监测提示弱酸反流SI阳性者2例，据此检查诊断烧心患者GERD的比例增至50％（22／44）。雷贝拉唑试验阳性4例，据此则将烧心患者诊断为GERD的比例增至54．5％（24／44）。结论联合食管MII—PH监测可增加GERD检出率。Objective To investigate the role of combined multichannel intralumminal impedanee-pH （MII-pH） monitoring in the diagnosis of gastroesophageal reflux disease （GERD）. Methods Forty-four consecutive patients, who had heartburn symptom and without esophageal mucosal lesion, underwent combined MII-pH monitoring. Then rabeprazole test was performed for 14 days with 10 mg twice daily. Rabeprazole test was defined as positive if patients were totally heartburn symptom free in the second week. The normal values from 70 healthy volunteers who underwent MII pH monitoring were served as controls. Results Conventional esophageal pH monitoring showed that 20 patients （45. 5%） had pathologic esophageal acid exposure or positive acid reflux associated symptom index. MII pH monitoring revealed that 2 patients were positive for weakly acidic reflux related to symptom index, thus increased the diagnostic yield to 50% （22/44）. Furthermore, rabeprazole test demonstrated that 4 patients were positive which increased the diagnostic yield to 54.5%（24/44）. Conclusion The detective rate of GERD will be elevated if combined with MII-pH monitoring in diagnosis.

关 键 词：胃食管反流 电阻抗 雷贝拉唑 

分 类 号：R686[医药卫生—骨科学]