Klauser A G, Heinrich C, Schindlbeck N E, Müller-Lissner S A
Department of Gastroenterology, University of Munich, Germany.
Am J Gastroenterol. 1989 Apr;84(4):362-6.
Two hundred eighty-nine patients with various chest symptoms were studied by interview for the presence and type of symptoms, and by long-term esophageal pH monitoring for acid reflux. One hundred eighty of the patients also had upper gastrointestinal endoscopy. There was significant correlation between the results of all three methods. pH monitoring was more sensitive (92.9% vs. 81.0%) and specific (41.3% vs. 23.9%), and classified more patients correctly (55.6% vs. 37.2%), than an interview by an experienced gastroenterologist when esophageal erosions were regarded as "gold standard" for pathologic reflux. Of all patients, 31.5% had unclear symptoms and therefore could not be diagnosed by interview alone. Forty nine percent of these had pathologic reflux on pH monitoring. Among the patients, 72.3% who had symptoms typical of reflux disease also had a pathologic result at pH monitoring. It is concluded that most patients with unambiguous symptoms of esophageal reflux can correctly be diagnosed by interview, but that esophageal pH monitoring has a role in the management of patients with less characteristic chest symptoms.
通过访谈研究了289例有各种胸部症状的患者，了解症状的存在情况和类型，并通过长期食管pH监测来检测酸反流。其中180例患者还接受了上消化道内镜检查。这三种方法的结果之间存在显著相关性。当将食管糜烂视为病理性反流的“金标准”时，pH监测比经验丰富的胃肠病学家进行的访谈更敏感（92.9%对81.0%）、更具特异性（41.3%对23.9%），且能正确分类更多患者（55.6%对37.2%）。在所有患者中，31.5%有不明确的症状，因此仅通过访谈无法确诊。其中49%在pH监测时有病理性反流。在这些患者中，有反流疾病典型症状的患者中有72.3%在pH监测时也有病理结果。结论是，大多数有明确食管反流症状的患者可通过访谈正确诊断，但食管pH监测在管理胸部症状不太典型的患者中具有作用。
