内镜引导下黏膜导纳测量可区分胃食管反流病与功能性烧心。
Endoscopic-Guided Measurement of Mucosal Admittance can Discriminate Gastroesophageal Reflux Disease from Functional Heartburn.
作者信息
Matsumura Tomoaki, Ishigami Hideaki, Fujie Mai, Taida Takashi, Kasamatsu Shingo, Okimoto Kenichiro, Saito Keiko, Maruoka Daisuke, Nakagawa Tomoo, Suzuki Takeshi, Katsuno Tatsuro, Arai Makoto
机构信息
Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Department of Clinical Engineering Center, Chiba University Hospital, Chiba, Japan.
出版信息
Clin Transl Gastroenterol. 2017 Jun 1;8(6):e94. doi: 10.1038/ctg.2017.22.
OBJECTIVES
A novel catheter that can measure mucosal admittance (MA), the inverse of impedance, was developed recently. In this pilot study, we aimed to clarify the usefulness of measuring MA for diagnosing gastroesophageal reflux disease (GERD).
METHODS
We conducted two prospective studies. In the first study, esophageal MA was evaluated in 120 participants (24 with erosive esophagitis, 82 with heartburn but non-erosive esophagitis, and 14 healthy volunteers) and compared with the endoscopic findings. In the second study, multichannel intraluminal impedance combined with pH (MII-pH) tests was conducted followed by an MA measurement in 33 patients with non-erosive esophagitis and proton pump inhibitor (PPI)-refractory heartburn. Based on the MII-pH test results, patients were divided into GERD or functional heartburn (FH). MA was compared between the GERD and FH groups and also compared with the baseline impedance (BI) and acid exposure time (AET).
RESULTS
Median MA at the distal esophagus was significantly higher in patients with erosive esophagitis compared with that in patients with non-erosive esophagitis and healthy volunteers (46.8, 13.1 and 6.5, respectively, P<0.01). In patients with PPI-refractory heartburn, the median MA at the distal esophagus was significantly higher in patients with GERD than those with FH (19.3 vs. 7.2, P<0.05). There was a negative correlation between MA and BI, and a positive correlation between MA and AET at the distal esophagus (r=-0.46 and r=0.53, P<0.05).
CONCLUSIONS
Real-time measurement of MA is useful to distinguish GERD from non-GERD.
目的
最近研发出一种能够测量黏膜导纳（MA，即阻抗的倒数）的新型导管。在这项初步研究中，我们旨在阐明测量MA对诊断胃食管反流病（GERD）的作用。
方法
我们进行了两项前瞻性研究。在第一项研究中，对120名参与者（24名糜烂性食管炎患者、82名有烧心症状但无糜烂性食管炎患者以及14名健康志愿者）的食管MA进行评估，并与内镜检查结果进行比较。在第二项研究中，对33名非糜烂性食管炎且质子泵抑制剂（PPI）治疗无效的烧心患者进行多通道腔内阻抗联合pH（MII-pH）测试，随后测量MA。根据MII-pH测试结果，将患者分为GERD组或功能性烧心（FH）组。比较GERD组和FH组之间的MA，同时与基线阻抗（BI）和酸暴露时间（AET）进行比较。
结果
糜烂性食管炎患者远端食管的MA中位数显著高于非糜烂性食管炎患者和健康志愿者（分别为46.8、13.1和6.5，P<0.01）。在PPI治疗无效的烧心患者中，GERD患者远端食管的MA中位数显著高于FH患者（19.3对7.2，P<0.05）。远端食管MA与BI呈负相关，与AET呈正相关（r=-0.46和r=0.53，P<0.05）。
结论
MA的实时测量有助于区分GERD与非GERD。
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