Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Am Coll Surg. 2010 Mar;210(3):345-50. doi: 10.1016/j.jamcollsurg.2009.12.006.
Patients with respiratory and laryngeal symptoms are commonly referred for evaluation of reflux disease as a potential cause. Dual-probe pH monitoring is often performed, although data on normal acid exposure in the proximal esophagus are limited because of the small number of normal subjects and inconsistent placement of the proximal pH sensor in relation to the upper esophageal sphincter. We measured proximal esophageal acid exposure using dual-probe pH and calculated a composite pH score in a large number of asymptomatic volunteers to better define normal values.
Eighty-one normal subjects free of reflux, laryngeal, or respiratory symptoms were recruited. All had video esophagraphy to exclude hiatal hernia. Esophageal pH monitoring was performed using 1 of 3 different dual-probe catheters with sensors spaced 10, 15, or 18 cm apart. The standard components of esophageal acid exposure were measured, excluding meal periods. A composite pH score for the proximal esophagus was calculated using these components.
The final study population consisted of 59 (49% male) subjects, with a median age of 27 years. All had normal distal esophageal acid exposure and no hiatal hernia. The 95(th) percentile values for the percent time the pH was < 4 for the total, upright, and supine periods were 0.9%, 1.2%, and 0.4%, respectively. The 95(th) percentile for the number of reflux episodes was 24 and for the calculated proximal esophageal composite pH score was 16.4.
In a large population of normal subjects, we have defined the normal values and calculated a composite pH score for proximal esophageal acid exposure. The total percent time pH < 4 was similar to previously published normal values, but the number of reflux episodes was greater.
有呼吸和喉部症状的患者常被转介来评估反流病是否为潜在病因。通常进行双探头 pH 监测，但由于正常受试者数量较少且近端 pH 传感器与食管上括约肌的位置不一致，因此有关近端食管酸暴露的正常数据有限。我们使用双探头 pH 测量了大量无症状志愿者的近端食管酸暴露情况，并计算了复合 pH 评分，以更好地定义正常值。
招募了 81 名无反流、喉或呼吸症状的正常受试者。所有受试者均进行了视频食管造影术以排除食管裂孔疝。使用 3 种不同的双探头导管之一进行食管 pH 监测，传感器之间的间隔为 10、15 或 18cm。测量了食管酸暴露的标准成分，不包括进餐期。使用这些成分计算了近端食管的复合 pH 评分。
最终研究人群包括 59 名（49%为男性）受试者，中位年龄为 27 岁。所有受试者的远端食管酸暴露均正常且无食管裂孔疝。总、直立和仰卧位时 pH 值<4 的时间百分比第 95 百分位数分别为 0.9%、1.2%和 0.4%。反流次数的第 95 百分位数为 24，计算的近端食管复合 pH 评分为 16.4。
在一个大的正常人群中，我们已经确定了正常值并计算了近端食管酸暴露的复合 pH 评分。总 pH 值<4 的时间百分比与之前发表的正常值相似，但反流次数更多。
