Shih G L, Brensinger C M, Katzka D A, Metz D C
Division of Gastroenterology, University of Pennsylvania Health Systems, Philadelphia, PA 19104, USA.
Aliment Pharmacol Ther. 2005 Jun 15;21(12):1475-82. doi: 10.1111/j.1365-2036.2005.02509.x.
Measurement of oesophageal acid exposure parameters postprandially has been shown to distinguish gastro-oesophageal reflux disease patients from normal individuals.
To calculate the accuracy of postprandial oesophageal integrated acidity in diagnosing gastro-oesophageal reflux disease.
Ambulatory 24-h pH studies of 626 patients were analysed retrospectively. Gastro-oesophageal reflux disease, defined as pH < 4 for > 4.2% of time, was identified in 305 subjects. Postprandial oesophageal integrated acidity was measured for 2 and 3 h after the largest meal peak as determined from gastric pH. Postprandial symptom-associated probability was calculated.
Gastro-oesophageal reflux disease subjects had a greater postprandial oesophageal integrated acidity than non-gastro-oesophageal reflux disease subjects [median (IQR): 0.57 (0.08-2.66) vs. 0.03 (0.01-0.15) mmolh/L]. Median postprandial oesophageal integrated acidity did not differ with gender or age in gastro-oesophageal reflux disease and non-gastro-oesophageal reflux disease subjects (P > 0.05 for all). A 3-h postprandial oesophageal integrated acidity value of 0.121 mmolh/L had a 71.1% sensitivity and 71.7% specificity in diagnosing gastro-oesophageal reflux disease. Gastro-oesophageal reflux disease subjects with symptoms had a higher postprandial oesophageal integrated acidity than those without (P = 0.043), whereas non-gastro-oesophageal reflux disease subjects with and without symptoms did not differ (P = 0.74). The correlation between symptom-associated probability and postprandial oesophageal integrated acidity was poor (gastro-oesophageal reflux disease: r = 0.15; non-gastro-oesophageal reflux disease: r = 0.25).
Postprandial oesophageal integrated acidity provides a robust estimation of oesophageal acid exposure and may predict symptoms in gastro-oesophageal reflux disease patients.
餐后食管酸暴露参数的测量已被证明可区分胃食管反流病患者与正常人。
计算餐后食管综合酸度在诊断胃食管反流病中的准确性。
对626例患者的24小时动态pH监测研究进行回顾性分析。将胃食管反流病定义为pH<4的时间超过4.2%，共识别出305例患者。根据胃pH值确定最大进餐峰值后，测量餐后2小时和3小时的食管综合酸度。计算餐后症状相关概率。
胃食管反流病患者的餐后食管综合酸度高于非胃食管反流病患者[中位数（四分位间距）：0.57（0.08 - 2.66）对0.03（0.01 - 0.15）mmol·h/L]。在胃食管反流病和非胃食管反流病患者中，餐后食管综合酸度中位数在性别和年龄方面无差异（所有P>0.05）。餐后3小时食管综合酸度值为0.121 mmol·h/L在诊断胃食管反流病时的敏感性为71.1%，特异性为71.7%。有症状的胃食管反流病患者的餐后食管综合酸度高于无症状者（P = 0.043），而有症状和无症状的非胃食管反流病患者之间无差异（P = 0.74）。症状相关概率与餐后食管综合酸度之间的相关性较差（胃食管反流病：r = 0.15；非胃食管反流病：r = 0.25）。
餐后食管综合酸度可对食管酸暴露进行可靠评估，并可能预测胃食管反流病患者的症状。
