Morozova Iu N, Pogromov A P, Mnatsakanian M G
Eksp Klin Gastroenterol. 2013(12):39-43.
To study potentials of 24-hour combined pH-impedance measurement in differential diagnosis of nonerosive reflux disease and functional gastroesophageal disorders.
Overall 60 patients with heartburn, belch and epigastric discomfort were investigated. All patients underwent esophagogastroduodenoscopy (EGDS), X-ray examination of upper gastrointestinal tract, 13C-urea breath test, 24-hour combined pH-impedance measurement.
Esophagitis grade 2-4 was diagnosed in 11 (18.3%) of 60 cases. In 49 (81.7%) no pathological changes were identify at EGDS and X-ray examination of upper gastrointestinal tract. Of them in 20 (33.3%) cases nonerosive reflux disease was revealed using 24-hour combined pH-impedance measurement. In 29 (48.3%) cases with the same clinical symptoms pH-impedance measurement data did not differ from normal, suggesting this group as group of patients with functional gastroesophageal disorders.
24-hour combined pH-impedance measurement is the most exact method which allows to identify gastroesophageal reflux episodes. On this basis in some cases it is possible to differentiate nonerosive reflux disease and functional gastroesophageal disorders. Application of pH-impedance measurement allows to recommend its introduction in wide clinical practice.
探讨24小时联合pH-阻抗测量在非糜烂性反流病和功能性胃食管疾病鉴别诊断中的潜力。
共对60例有烧心、嗳气和上腹部不适症状的患者进行了研究。所有患者均接受了食管胃十二指肠镜检查(EGDS)、上消化道X线检查、13C尿素呼气试验、24小时联合pH-阻抗测量。
60例患者中,11例(18.3%)诊断为2-4级食管炎。49例(81.7%)在EGDS和上消化道X线检查中未发现病理改变。其中,20例(33.3%)通过24小时联合pH-阻抗测量发现非糜烂性反流病。29例(48.3%)有相同临床症状的患者,其pH-阻抗测量数据与正常无异,提示该组为功能性胃食管疾病患者。
24小时联合pH-阻抗测量是识别胃食管反流发作最准确的方法。在此基础上,在某些情况下可以鉴别非糜烂性反流病和功能性胃食管疾病。pH-阻抗测量的应用使其有望在广泛的临床实践中得到推广。