食管测压联合食管PH-阻抗监测对非典型症状GERD的诊断价值  

Value of high resolution esophageal manometry combined with 24-hour esophageal pH impedance monitoring in diagnosis and evaluation of atypical GERD

作　　者：古岳 雷鸽[1] 范筱[1] GU Yue;LEI Ge;FAN Xiao(Department of Gastroenterology,Nanyang Second People's Hospital,Nanyang,Henan,China,73000)

机构地区：[1]南阳市第二人民医院消化内科,河南南阳473000

出　　处：《分子诊断与治疗杂志》2022年第2期321-324,共4页Journal of Molecular Diagnostics and Therapy

基　　金：2018年河南省医学科技攻关计划(2018020985)。

摘　　要：目的探讨高分辨率食管测压联合24小时食管PH-阻抗监测对非典型症状胃食管反流病(GERD)的诊断价值。方法选取2018年7月至2020年7月以南阳市第二人民医院收治的非典型症状GERD患者150例(病例组),对照组150例(同期健康体检者)。病例组其中糜烂性食管炎(EE)组32例、非糜烂性反流病(NERD)组118例,对照组(同期健康体检者),均行高分辨率食管测压、24小时食管PH阻抗监测,收集纳入患者电子胃镜检查结果,比较探讨高分辨率食管测压联合24小时食管PH-阻抗检测对非典型症状GERD的诊断及评估价值。结果三组收缩前沿速度(CFA)、远端收缩积分(DIC)依次递增,差异有统计学意义(P<0.05),其中EE组、NERD组CFA、DIC低于对照组,差异有统计学意义(P<0.05),且EE组CFA、DIC低于NERD组,差异有统计学意义(P<0.05)。EE组、NERD组、对照组pH<4次数/次、最长反流时间指标中上、下电极参数均依次递减,差异有统计学意义(P<0.05),其中EE组、NERD组上述指标均明显高于对照组,且EE组各指标参数均明显高于NERD组,差异有统计学意义(P<0.05)。病例组(EE组+NERD组)和对照组分别采用联合检测法(高分辨率食管测压联合24小时食管PH阻抗监测)诊断试验评估,灵敏度=83.58%、特异度=90.36%,准确率=87.33%,kappa值=0.743。结论高分辨率食管测压联合24小时食管PH阻抗监测对非典型症状GERD的诊断准确性较高,且优于单用传统DH-Meester积分法分析24小时PH-DeM,且一定程度上辅助性的提高了对非典型症状GERD的诊断的准确性,为非典型症状GERD的及时诊断和治疗提供参考。Objective To investigate the diagnostic value of high-resolution esophageal manometry combined with 24-hour esophageal pH impedance monitoring in patients with atypical GERD.Methods From July 2018 to July 2020,150 patients with GERD with atypical symptoms(case group)and150 healthy people(control group)were enrolled.case group,including 32 erosive esophagitis(EE)and non erosive reflux disease(non erosive esophagitis),118 cases of NERD(group B)and the control group(Group C).The results of electronic gastroscopy were collected and compared to explore the diagnostic and evaluation value of high-resolution esophageal manometry combined with 24-hour esophageal pH impedance test in patients with atypical symptoms of GERD.Result The CFA and DIC of the EE group,NERD group and the control group increased sequentially,and the difference was statistically significant(P<0.05).The CFA and DIC of the EE group and the NERD group were lower than those of the control group,the difference was statistically significant(P<0.05),and the CFA and DIC of the EE group were lower than those of the NERD group,the difference was statistically significant(P<0.05).In the EE group,NERD group,and control group,p H<4 times/time,and the parameters of the longest reflux time in the upper and lower electrode parameters decreased in sequence,the difference was statistically significant(P<0.05).Among them,the above indexes of EE group and NERD group were significantly higher than those of the control group.And each index parameter of EE group was significantly higher than that of NERD group,the difference was statistically significant(P<0.05).The case group(EE group+NERD group)and the control group were evaluated by the combined detection method(high-resolution esophageal pressure measurement combined with 24-hour esophageal PH impedance monitoring)diagnostic test,sensitivity=83.58%,specificity=90.36%,accuracy=87.33%,kappa value=0.743.Conclusion High-resolution esophageal manometry combined with 24-hour esophageal PH impedance monitoring has a higher

关 键 词：高分辨率食管测压 24小时食管PH-阻抗监测 GERD 24小时PH-DeM法 

分 类 号：R571[医药卫生—消化系统]