基于24 h pH及阻抗监测的胃食管反流性咳嗽反流特点分析  

Analysis of Reflux Characteristics of Gastroesophageal Reflux Cough Based on 24-hour pH and Impedance Monitoring

作　　者：曾艳凌[1] 林晗 黄胡萍[1] 林志辉[1] ZENG Yan-ling;LIN HAN;HUANG Hu-ping;LIN Zhi-hui(Provincial Clinical College,Fujian Medical University,Gastroenterology Department,Fujian Provincial Hospital,Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院消化内科,福建福州350001

出　　处：《中外医疗》2018年第28期4-6,共3页China & Foreign Medical Treatment

摘　　要：目的应用24 h食管多通道腔内阻抗-pH监测(multichannel intraluminal esophageal impedance and pH monitoring,MII-pH)探讨胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)的反流特点。方法方便收集2016年3月—2018年5月就诊福建省立医院的GERC患者46例,典型GERD组32例,健康对照组30名,所有患者经过高分辨测压及MII-pH监测,比较DeMeester积分、酸、弱酸、非酸、液体、混合、气体及近端反流次数不同。结果 GERC组与健康对照组相比,DeMeester积分[13.2(2.6～260.03) vs 0.97(0.2-9.78)]、酸[40.9(0～190.2) vs 4.5(0～22.6)]、弱酸[65.0(4.4～197.0) vs 29.6(0～97.0)]、液体[53.7(13.2～181.2) vs 17.8(3.4～100.4)]、混合[64.1(14.6～203.2) vs 20.6(0～85.7)]、非酸[6.5(0～227.0) vs 2.2(0～88)]、气体[37.0(5.4-416.3) vs 20.3(3.5～32.7)]、近端反流[13.5(0～79.8) vs 1.6(0～11.5)]结果均明显升高(P<0.05);与典型GERD组相比,GERC组De Meester积分[13.2(2.6～260.03)vs 18.6(3.21～276.77)]、酸反流次数[40.9(0～190.2) vs 63.5(31.9～172.4)]均明显减低(P<0.05),气体反流[37.0(5.4～416.3)vs 22.9(3.3～98.7)]、近端反流次数[13.5(0～79.8) vs 4.7(0～33.5)]明显升高(P<0.05)。非酸、弱酸、混合反流次数与典型GERD组相仿(P>0.05)。结论GERC患者存在异常反流,气体反流及近端反流异常可能是GERD患者导致GERC的原因。Objective This paper tries to investigate the reflux characteristics of gastroesophageal reflux cough （GERC） by using muhichannel intraluminal esophageal impedance and pH monitoring （MII-pH）. Methods Forty-six patients with GERC from Fujian Provincial Hospital from March 2016 to May 2018 were convenient enrolled, including 32 patients in the typical GERD group and 30 healthy in the control group. All patients were compared with DeMeester by high-resolution manometry and MII-pH monitoring. The number of integrals, acids, weak acids, non-acids, liquids, mixtures, gases, and proximal reflux was different. Results DeMeester scores （13.2 （2.6-260.03） vs. 0.97 （0.2-9.78））, acid （40.9 （0-190.2） vs 4.5 （0-22.6））, weak acid GERC group cornpareal to the healthy control group, [65.0 （4.4-197.0） vs 29.6 （0-97.0）], liquid [53.7 （13.2-181.2） vs 17.8 （3.4-100.4）], mixed [64.1 （14.6-203.2） vs 20.6 （0-85.7）], non-acid [6.5 （0-227.0） vs 2.2 （0-88）], gas [37.0 （5.4-416.3） vs 20.3 （3.5-32.7）], proximal reflux [13.5 （0-79.8） vs 1.6 （0-11.5）] were significantly increased （P〈0.05）. Compared with the typical GERD group, the DeMeester score of the GERC group [13.2 （2.6-260.03） vs 18.6 （3.21-276.77）], acid counter The number of flow [40.9 （0-190.2） vs 63.5 （31.9-172.4）] was significantly reduced （P〈0.05）, gas reflux [37.0 （5.4-416.3） vs 22.9 （3.3-98.7）], proximal end The number of flows [13.5 （0-79.8） vs 4.7 （0-33.5）] was significantly increased （P〈0.05）. The number of non-acid, weak acid and mixed reflux was similar to that of the typical GERD group （P〉 0.05）. Conclusion Abnormal reflux in patients with GERC, gas reflux and proximal reflux abnormalities may be responsible for GERC in patients with GERD.

关 键 词：胃食管反流性咳嗽 典型胃食管反流 24 H pH及阻抗监测 

分 类 号：R57[医药卫生—消化系统]