Department of Gastroenterology and Hepatology and Center for Swallowing and Esophageal Disorders, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
Am J Gastroenterol. 2011 Feb;106(2):183-5. doi: 10.1038/ajg.2010.318.
The role of esophageal pH (or impedance) monitoring in diagnosing gastroesophageal reflux disease (GERD) has evolved over the years. In the era of empiric therapy with potent acid-suppressive agents such as proton pump inhibitors (PPIs), esophageal reflux monitoring is often reserved for patients with PPI-refractory symptoms (1, 2). Given the complexity of patient presentations, technological advancement, and emerging data in the field of GERD, two essential questions need to be addressed: (i) What are the indications for esophageal pH testing in patients suspected to have GERD? (ii) If patients do not respond to aggressive acid suppression, what is the likelihood that they still have reflux; and should the testing be performed at baseline (i.e., off therapy), or is it more important to know whether there is continued reflux despite therapy (i.e., on therapy)?
食管 pH（或阻抗）监测在诊断胃食管反流病（GERD）中的作用多年来一直在发展。在经验性治疗质子泵抑制剂（PPIs）等强效抑酸剂的时代，食管反流监测通常仅用于 PPI 难治性症状的患者（1,2）。鉴于患者表现的复杂性、技术的进步和 GERD 领域新出现的数据，需要解决两个基本问题：（i）怀疑患有 GERD 的患者进行食管 pH 测试的适应证有哪些？（ii）如果患者对积极的抑酸治疗没有反应，他们仍有反流的可能性有多大；并且应该在基线时（即停药时）进行测试，还是更重要的是要知道尽管进行了治疗是否仍有反流（即治疗时）？
