【摘要】 目的评估24 h多通道食管阻抗-pH监测在鉴别诊断非糜烂性反流病(NERD)和功能性烧心(FH)中的作用。方法选取有典型GERD症状且内镜检查阴性的患者132例及20例健康志愿者进行24 h多通道食管阻抗-pH监测,分析食管酸暴露时间(AET)、各种反流事件及反流症状相关概率(SAP)。结果根据食管异常AET和SAP,132例患者分为:48例(36%)为病理性酸反流组(NERD pH阳性组),51例(39%)为pH阴性/SAP阳性组(HO组)和33例(25%)pH阴性/SAP阴性组(FH组)。NERD pH阳性组总反流次数、酸反流次数、液体反流次数、AET、食团清除时间较HO组、FH组及对照组显著增加;HO组总反流次数、酸反流次数、弱酸反流次数、AET较FH组及对照组明显增多;NERD pH阳性组和HO组近端反流次数较FH组及对照组明显增多;FH组和对照组之间各项指标无统计学差异。结论 NERD和FH患者24 h多通道食管阻抗-pH监测结果有显著差异,可为临床鉴别诊断和治疗提供一定的依据。更多还原

【Abstract】 Objective To assess the contribution of 24-hour multichannel intraluminal esophageal impedance-pH monitoring(MII-pH) in differentiating non-erosive reflux disease(NERD) from functional heartburn(FH). Methods 132 Endoscopy-negative reflux patients and 20 healthy volunteers(HVs) underwent 24-h MII-pH monitoring. Oesophageal acid exposure time(AET), characteristics of reflux episodes and symptom association probability(SAP)were analyzed. Results Based on abnormal AET and SAP, of 132 patients, 48(36%)was abnormal acid reflux(NERD/pH-POS), 51(39%)pH-NEG/SAP+(hypersensitive oesophagus, HO)and 33(25%)pH-NEG/SAP-(FH). The number of total, acid and liquid reflux episodes, AET, and bolus clearance time were significantly higher in NERD/pH-POS compared to HO, FH and HVs. Patients with HO had significantly increased number of total, acid and weakly acid reflux episodes and AET compared to FH and HVs. The rate of proximal reflux episodes in NERD/pH-POS and HO was higher than in FH and HVs. There was no significant difference of the parameters between FH and HVs. Conclusions There are significant differences in MII-pH patterns between NERD and FH. These differences can be help in differentiating and treating NERD and FH in clinic.更多还原