Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt Medical Center, Nashville, TN 37232-5280, USA.
Clin Gastroenterol Hepatol. 2012 Oct;10(10):1110-6. doi: 10.1016/j.cgh.2012.05.018. Epub 2012 May 27.
BACKGROUND & AIMS: Diagnostic tests for gastroesophageal reflux disease (GERD) are constrained because measurements are made at a single time point, so the long-term effects on the mucosa cannot be determined. We developed a minimally invasive system to assess changes in esophageal mucosal impedance (MI), a marker of reflux. We measured the extent of changes in MI along the esophagus and show that the device to assess MI can be used to diagnose patients with GERD.
A single-channel MI catheter composed of a unique sensor array was designed to easily traverse the working channel of an upper endoscope. We performed a prospective longitudinal study of patients with erosive esophagitis (n = 19), nonerosive but pH-positive GERD (n = 23), and those without GERD (n = 27). MI was measured at the site of esophagitis as well as 2, 5, and 10 cm above the squamocolumnar junction. The MI values were compared among groups, at different levels along the esophageal axis.
Median MI values were significantly lower at the site of erosive mucosa (811 Ω; range, 621-1272 Ω) than other nonerosive regions (3723 Ω; range, 2421-4671 Ω; P = .001), and were significantly lower at 2 cm above the squamocolumnar junction in patients with GERD (2096 Ω; range, 1415-2808 Ω), compared with those without GERD (3607 Ω; range, 1973-4238 Ω; P = .008). There was a significant and graded increase in MI along the axis of the distal to proximal esophagus in patients with GERD that was not observed in individuals without reflux (P = .004).
Measurements of MI along the esophagus can be used to identify patients with GERD. ClinicalTrials.gov, number NCT01194323.
诊断胃食管反流病（GERD）的检测方法受到限制，因为这些检测都是在单一时间点进行的，因此无法确定其对黏膜的长期影响。我们开发了一种微创系统来评估食管黏膜阻抗（MI）的变化，这是一种反流的标志物。我们测量了 MI 在食管上的变化程度，并表明用于评估 MI 的设备可用于诊断 GERD 患者。
设计了一种由独特传感器阵列组成的单通道 MI 导管，以便于在胃镜的工作通道中穿行。我们对 19 例糜烂性食管炎患者、23 例非糜烂性但 pH 阳性 GERD 患者和 27 例无 GERD 患者进行了前瞻性纵向研究。在食管炎部位以及距鳞柱状交界 2、5 和 10 cm 处测量 MI。比较了各组之间、食管轴不同水平处的 MI 值。
糜烂性黏膜部位的 MI 值中位数明显低于其他非糜烂区域（811 Ω；范围，621-1272 Ω；P =.001），且 GERD 患者在距鳞柱状交界 2 cm 处的 MI 值中位数明显低于无 GERD 患者（2096 Ω；范围，1415-2808 Ω；P =.008）。在 GERD 患者中，沿着食管远端到近端的轴，MI 值呈显著且分级增加，而在无反流的个体中则没有观察到这种情况（P =.004）。
沿食管测量 MI 可用于识别 GERD 患者。ClinicalTrials.gov 注册号：NCT01194323。
