Ye Bi Xing, Jiang Liu Qin, Lin Lin, Wang Ying, Wang Meifeng
Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University Department of Gastroenterology, Jiangsu Province Official Hospital, Nanjing, Jiangsu, China.
Medicine (Baltimore). 2017 Sep;96(37):e7978. doi: 10.1097/MD.0000000000007978.
To determine the relationship between baseline impedance levels and gastroesophageal reflux, we retrospectively enrolled 110 patients (54 men and 56 female; mean age, 51 ± 14 years) with suspected gastroesophageal reflux disease (GERD) who underwent 24-h multichannel intraluminal impedance and pH monitoring. Patients were stratified according to symptom (typical or atypical) and reflux types (acid reflux, nonacid reflux [NAR], or no abnormal reflux). Mean nocturnal baseline impedance (MNBI) were measured 3 cm (distal esophagus) and 17 cm (proximal esophagus) above the lower esophageal sphincter. Median distal esophageal MNBI was lower in the acid reflux group (1244 Ω; 647-1969 Ω) than in the NAR (2586 Ω; 1368-3666 Ω) or no abnormal reflux groups (3082 Ω; 2495-4472 Ω; all P < .05). Distal MNBI were negatively correlated with DeMeester score and acid exposure time. Atypical symptoms were more frequently associated with NAR than typical symptoms (P < .01). Among patients with positive symptom-association probability (SAP) for NAR, median proximal MNBI tended to be lower in patients with typical symptoms (median, 3013 Ω; IQR, 2535-3410 Ω) than in those with atypical symptoms (median, 3386 Ω; IQR, 3044-3730 Ω, P = .05). Thus, atypical GERD symptoms were more likely to be associated with NAR. The mucosal integrity of the proximal esophagus might be relatively impaired in GERD patients with typical symptoms for NAR.
为了确定基线阻抗水平与胃食管反流之间的关系，我们回顾性纳入了110例疑似胃食管反流病（GERD）的患者（54例男性和56例女性；平均年龄51±14岁），这些患者接受了24小时多通道腔内阻抗和pH监测。患者根据症状（典型或非典型）和反流类型（酸反流、非酸反流[NAR]或无异常反流）进行分层。在下食管括约肌上方3 cm（食管远端）和17 cm（食管近端）处测量平均夜间基线阻抗（MNBI）。酸反流组的食管远端MNBI中位数（1244Ω；647 - 1969Ω）低于NAR组（2586Ω；1368 - 3666Ω）或无异常反流组（3082Ω；2495 - 4472Ω；所有P < 0.05）。远端MNBI与DeMeester评分和酸暴露时间呈负相关。非典型症状比典型症状更常与NAR相关（P < 0.01）。在NAR症状关联概率（SAP）为阳性的患者中，典型症状患者的食管近端MNBI中位数（中位数，3013Ω；IQR，2535 - 3410Ω）往往低于非典型症状患者（中位数，3386Ω；IQR，3044 - 3730Ω，P = 0.05）。因此，非典型GERD症状更可能与NAR相关。对于NAR有典型症状的GERD患者，食管近端的黏膜完整性可能相对受损。
