高分辨率食管测压联合24h食管阻抗-pH监测对胃食管反流病病情程度的诊断价值  

Diagnostic value of high-resolution esophageal manometry combined with 24 h esophageal impedance-pH monitoring for the severity of gastroesophageal reflux disease

作　　者：李少英 杨亚莉[1] 张志强[1] Li Shaoying;Yang Yali;Zhang Zhiqiang(Department of Gastroenterology,Xinxiang First People's Hospital,Xinxiang,Henan 453000,China)

机构地区：[1]新乡市第一人民医院消化内科,河南新乡453000

出　　处：《现代临床医学》2024年第6期425-428,共4页Journal of Modern Clinical Medicine

摘　　要：目的:分析高分辨率食管测压(HRM)联合24 h食管阻抗-pH监测对胃食管反流病(GERD)病情程度的诊断价值。方法:选取2020年8月至2023年7月我院确诊GERD的182例患者为研究对象,依据DeMeester积分分为轻度组(≤50分)、中度组(51~100分)、重度组(>100分),比较HRM指标与24h阻抗-pH监测指标,分析这些指标与GERD病情程度的相关性及其诊断价值。结果:3组腹段食管下括约肌(LES)长度比较,轻度组>中度组>重度组(P<0.05);3组气体反流次数、平均酸清除时间、酸反流次数比较,轻度组<中度组<重度组(P<0.05);GERD病情程度与腹部LES长度呈负相关,与气体反流次数、平均酸清除时间、酸反流次数呈正相关(P<0.05)。气体反流次数、平均酸清除时间、酸反流次数、腹部LES长度单独诊断GERD的ROC曲线下面积均小于HRM与24h阻抗-pH监测联合诊断(P<0.05)。结论:HRM联合24h阻抗-pH监测GERD,可有效判断GERD病情程度,有助于临床制定针对性治疗方案。Objective:To analyze the diagnostic value of high-resolution esophageal manometry(HRM)combined with 24 h esophageal impedance-pH monitoring for the severity of gastroesophageal reflux disease(GERD).Methods:A total of 182 patients diagnosed with GERD in our hospital from August 2020 to July 2023 were selected as the research objects.They were divided into mild group(≤50 points),moderate group(51-100 points),and severe group(>100 points)according to the DeMeester score.The HRM indexes and 24 h impedance-pH monitoring indexes were compared,and the correlations between these indexes and the severity of GERD and their diagnostic value were analyzed.Results:The length of the abdominal segment of the lower esophageal sphincter(LES)was compared among the three groups,and it was mild group>moderate group>severe group(P<0.05).The number of gas reflux,average acid clearance time,and number of acid reflux were compared among the three groups,and it was mild group<moderate group<severe group(P<0.05).The severity of GERD was negatively correlated with the length of the abdominal LES and positively correlated with the number of gas reflux,average acid clearance time,and number of acid reflux(P<0.05).When the number of gas reflux,average acid clearance time,number of acid reflux,and length of abdominal LES were used for individual diagnosis,the area under the ROC curve for moderate or severe GERD was smaller than that of the combined diagnosis of HRM and 24 h impedance-pH monitoring(P<0.05).Conclusion:HRM combined with 24 h impedancepH monitoring for GERD can effectively determine the severity of GERD and is helpful for the clinic to formulate targeted treatment plans.

关 键 词：高分辨率食管测压 24 h食管阻抗-pH监测 胃食管反流病 病情程度 

分 类 号：R571[医药卫生—消化系统]