基于食管pH-阻抗监测的A级与B/C级反流性食管炎患者的反流特征比较  

Comparison of reflux characteristics between grade A and grades B/C reflux esophagitis based on esophageal pH-impedance monitoring

作　　者：林思慧 陈志龙 朱宇诚 蒋炜 孙达龙 LIN Sihui;CHEN Zhilong;ZHU Yucheng;JIANG Wei;SUN Dalong(Department of Gastroenterology and Hepatology,Zhongshan Hospital(Xiamen Branch),Fudan University,Xiamen 361015,Fujian,China;Department of Gastroenterology and Hepatology,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院厦门医院消化科,厦门363015 [2]复旦大学附属中山医院消化科,上海200032

出　　处：《中国临床医学》2024年第6期918-924,共7页Chinese Journal of Clinical Medicine

基　　金：福建省自然科学基金重点项目(2021D033);厦门市医疗卫生指导性项目(3502Z20224ZD1084).

摘　　要：目的基于食管pH-阻抗监测,比较洛杉矶(LA)分级中的A级与B/C级反流性食管炎(reflux esophagitis,RE)患者的反流特征。方法回顾性连续纳入2021年6月至2024年6月在复旦大学附属中山医院厦门医院就诊的74例RE患者,根据内镜检查结果分为LA-A组(n=46)和LA-B/C组(n=28)。比较两组患者的一般资料、症状问卷评分、食管24 h pH-阻抗监测结果。结果LA-A组和LA-B/C组患者人口学资料、抑酸治疗反应率差异无统计学意义。24 h食管pH-阻抗监测结果显示,两组患者的立位、卧位及总体酸反流次数、酸暴露时间(acid exposure time,AET)、AET%、长酸反流次数、最长酸反流持续时间,以及总体DeMeester评分差异均无统计学意义;两组食管远端反流次数,近端反流次数,高位反流中的酸反流、弱酸反流、非酸反流次数,以及平均夜间基线阻抗差异均无统计学意义。LA-A组与LA-B/C组病理性反流(AET%≥6%)患者分别占67.4%、71.4%;两组患者AET%分布、24 h阻抗监测的反流次数大于80次的比例差异均无统计学意义。结论LA-A级RE的内镜诊断有助于识别中国人群胃食管反流病。Objective To compare the reflux characteristics between reflux esophagitis(RE)patients with Los Angeles(LA)classification grade A and grades B/C based on esophageal pH-impedance monitoring results.Methods A total of 74 RE patients at Zhongshan Hospital(Xiamen Branch),Fudan University from June 2021 to June 2024 were enrolled,and were divided into the LA-A group(n=46)and the LA-B/C group(n=28)based on the endoscopic diagnosis results.The general clinical data,symptom questionnaire score,and esophageal 24-hour pH-impedance monitoring results were compared between the two groups.Results There were no statistically significant differences in demographic data and the response rate of acid suppression therapy between the two groups.24-hour esophageal pH-impedance monitoring results showed that there were no statistically significant differences in upright,supine,and total reflux indices,including reflux episodes,acid exposure time(AET),AET percentage(AET%),long acid reflux episodes,longest reflux duration,and total DeMeester score between the two groups.There were no statistically significant differences in distal reflux episodes,proximal reflux episodes,and high reflux(acid,weak acid,and non�acidic reflux)episodes,mean nocturnal baseline impedance(MNBI)between the two groups.The rates of pathological reflux(AET%≥6%)in LA-A group and LA-B/C group were 67.4%and 71.4%,respectively;there were no statistically significant differences in the ratio of AET%composition and the count of impedance reflux exceeding 80 during 24 h between the two groups.Conclusions LA-A grade RE based on the endoscopic diagnosis facilitates the identification of gastroesophageal reflux disease in the Chinese population。

关 键 词：反流性食管炎 胃食管反流病 食管pH-阻抗监测 里昂共识 

分 类 号：R571[医药卫生—消化系统]