Corvaglia L, Mariani E, Aceti A, Capretti M G, Ancora G, Faldella G
Neonatology and Neonatal Intensive Care Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Neurogastroenterol Motil. 2009 Oct;21(10):1027-e81. doi: 10.1111/j.1365-2982.2009.01301.x. Epub 2009 Mar 30.
Gastro-oesophageal reflux (GOR) is common in preterm infants. Combined multichannel intraluminal impedance and pH monitoring (pH-MII) is emerging as an useful tool to study both acid and non-acid GOR in this population. We aimed to highlight main advantages and limits of pH-MII in preterm infants and to test whether the inclusion of GOR episodes detected only by pH monitoring details better the features of GOR. Fifty-two symptomatic preterm infants underwent a 24-hour, continuous and simultaneous measurement of pH-MII. Each layout was analyzed using two different options: option 1 included GOR episodes detected by MII and then classified as acid or non-acid according to the associated pH change; option 2 included GOR episodes detected by MII and also GOR episodes detected only by pH sensor. By adopting option 1, a total number of 2834 GOR episodes was detected by MII: 2162 of them were characterized as non-acid and 672 were characterized as acid. The median (range) number of acid MII-GOR episodes was 10 (1-52); the median (range) number of non-acid MII-GOR episodes was 36.5 (2-119). Median (range) acid MII-GOR-bolus exposure index was 0.28% (0.02-2.73%); median (range) non-acid MII-GOR-bolus exposure index was 1.03% (0.06-38.15%). By adopting option 2, an average of 53.2 acid GOR episodes and an average of 11% oesophageal exposure to acid GOR more than by option 1 was detected. An accurate and detailed description of GOR in preterm infants can be obtained only by including in the analysis all acid GOR episodes detected by pH sensor.
胃食管反流（GOR）在早产儿中很常见。联合多通道腔内阻抗和pH监测（pH-MII）正逐渐成为研究该人群酸性和非酸性GOR的有用工具。我们旨在强调pH-MII在早产儿中的主要优点和局限性，并测试仅通过pH监测检测到的GOR发作是否能更详细地描述GOR的特征。52名有症状的早产儿接受了24小时连续同步的pH-MII测量。每个测量结果使用两种不同的方法进行分析：方法1包括由MII检测到的GOR发作，然后根据相关的pH变化分为酸性或非酸性；方法2包括由MII检测到的GOR发作以及仅由pH传感器检测到的GOR发作。采用方法1时，MII共检测到2834次GOR发作：其中2162次为非酸性，672次为酸性。酸性MII-GOR发作的中位数（范围）为10（1-52）；非酸性MII-GOR发作的中位数（范围）为36.5（2-119）。酸性MII-GOR团注暴露指数的中位数（范围）为0.28%（0.02-2.73%）；非酸性MII-GOR团注暴露指数的中位数（范围）为1.03%（0.06-38.15%）。采用方法2时，平均检测到53.2次酸性GOR发作，且食管酸性GOR暴露平均比方法1多11%。只有将pH传感器检测到的所有酸性GOR发作纳入分析，才能获得早产儿GOR的准确详细描述。
