Department of Gastroenterology, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China.
J Gastroenterol. 2013 May;48(5):601-10. doi: 10.1007/s00535-012-0689-6. Epub 2012 Oct 18.
The esophageal intraluminal baseline impedance may be used to evaluate the status of mucosa integrity. Esophageal acid exposure decreases the baseline impedance. We aimed to compare baseline impedance in patients with various reflux events and with different acid-related parameters, and investigate the relationships between epithelial histopathologic abnormalities and baseline impedance.
A total of 229 GERD patients and 34 controls underwent 24-h multichannel intraluminal impedance and pH monitoring (MII-pH monitoring), gastroendoscopy, and completed a GERD questionnaire (GerdQ). We quantified epithelial intercellular spaces (ICSs) and expression of tight junction (TJ) proteins by histologic techniques.
Mean baseline values in reflux esophagitis (RE) (1752 ± 1018 Ω) and non-erosive reflux disease (NERD) (2640 ± 1143 Ω) were significantly lower than in controls (3360 ± 1258 Ω; p < 0.001 and p = 0.001, respectively). Among NERD subgroups, mean baselines in the acid reflux group (2510 ± 1239 Ω) and mixed acid/weakly acidic reflux group (2393 ± 1009 Ω) were much lower than in controls (3360 ± 1258 Ω; p = 0.020 and p < 0.001, respectively). The mean baseline in severe RE patients was significantly lower than in mild RE patients (LA-C/D vs. LA-A/B: 970 ± 505 Ω vs. 1921 ± 1024 Ω, p < 0.001). There was a significant negative correlation between baseline value and acid exposure time (AET) (r = -0.41, p < 0.001), and a weak but significant correlation (r = -0.20, p = 0.007) between baseline value and weakly AET. Negative correlations were observed between ICS and the baseline impedance (r = -0.637, p < 0.001) and claudin-1 and the baseline impedance (r = -0.648, p < 0.001).
Patients with dominant acid reflux events and with longer AET have low baseline impedance. Baseline values are correlated with esophageal mucosal histopathologic changes such as dilated ICS and TJ alteration.
食管腔内基础阻抗可用于评估黏膜完整性状态。食管酸暴露会降低基础阻抗。我们旨在比较各种反流事件和不同酸相关参数患者的基础阻抗，并探讨上皮组织病理学异常与基础阻抗之间的关系。
共 229 例胃食管反流病（GERD）患者和 34 例对照者接受 24 小时多通道腔内阻抗-pH 监测（MII-pH 监测）、胃内视镜检查，并完成胃食管反流病问卷（GerdQ）。我们通过组织学技术量化上皮细胞间空间（ICS）和紧密连接（TJ）蛋白的表达。
反流性食管炎（RE）（1752 ± 1018 Ω）和非糜烂性反流病（NERD）（2640 ± 1143 Ω）的平均基础值明显低于对照组（3360 ± 1258 Ω；p < 0.001 和 p = 0.001）。在 NERD 亚组中，酸反流组（2510 ± 1239 Ω）和混合酸/弱酸性反流组（2393 ± 1009 Ω）的平均基础值明显低于对照组（3360 ± 1258 Ω；p = 0.020 和 p < 0.001）。严重 RE 患者的平均基础值明显低于轻度 RE 患者（LA-C/D 比 LA-A/B：970 ± 505 Ω 比 1921 ± 1024 Ω，p < 0.001）。基础值与酸暴露时间（AET）呈显著负相关（r = -0.41，p < 0.001），与弱酸性 AET 呈弱但显著相关（r = -0.20，p = 0.007）。ICS 与基础阻抗呈显著负相关（r = -0.637，p < 0.001），claudin-1 与基础阻抗呈负相关（r = -0.648，p < 0.001）。
具有主要酸反流事件和较长 AET 的患者基础阻抗较低。基础值与食管黏膜组织病理学变化相关，如 ICS 扩张和 TJ 改变。
