Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China.
Chron Respir Dis. 2021 Jan-Dec;18:14799731211006682. doi: 10.1177/14799731211006682.
To elucidate the accuracy and advantages of Multichannel intraluminal impedance-pH monitoring (MII-pH) in diagnosing gastroesophageal reflux-induced chronic cough (GERC).
The patients with suspected GERC were recruited and underwent MII-pH, GERC was confirmed by subsequent anti-reflux treatment despite the findings of MII-pH. Its diagnostic accuracy in identifying GERC were evaluated by receiver operating characteristic (ROC) analysis and compared with that of 24-h esophageal pH monitoring.
Among 158 patients completing both MII-pH and anti-reflux therapy, GERC was diagnosed in 136 patients, including acid GERC in 96 patients (70.6%), non-acid GERC in 30 patients (22.0%), neither one of both GERC in 10 patients (7.4%). For the identification of GERC, MII-pH presented with the sensitivity of 92.6%, specificity of 63.6%, positive predictive value of 94.0%, negative predictive value of 58.3% and area under ROC curve of 0.863, which was totally superior to 24-h esophageal pH monitoring. As the essential criteria of MII-pH, esophageal acid exposure time and symptom associated probability had a limited diagnostic value when used alone, but improved greatly the diagnostic yield when used in combination, even with a suboptimal efficacy.
MII-pH is a more sensitive test for identifying GERC, but with a suboptimal diagnostic efficacy.
阐明多通道腔内阻抗-pH 监测（MII-pH）在诊断胃食管反流引起的慢性咳嗽（GERC）中的准确性和优势。
招募疑似 GERC 的患者，并进行 MII-pH 检查，尽管 MII-pH 检查结果正常，但随后通过抗反流治疗来确认 GERC。通过接受者操作特征（ROC）分析评估其在识别 GERC 中的诊断准确性，并与 24 小时食管 pH 监测进行比较。
在完成 MII-pH 和反流治疗的 158 例患者中，136 例诊断为 GERC，包括 96 例（70.6%）酸反流性 GERC、30 例（22.0%）非酸反流性 GERC、10 例（7.4%）两者均无。对于 GERC 的识别，MII-pH 的敏感性为 92.6%，特异性为 63.6%，阳性预测值为 94.0%，阴性预测值为 58.3%，ROC 曲线下面积为 0.863，这完全优于 24 小时食管 pH 监测。作为 MII-pH 的基本标准，食管酸暴露时间和症状相关概率单独使用时诊断价值有限，但联合使用时诊断效果大大提高，即使效果不理想。
MII-pH 是一种更敏感的 GERC 识别测试，但诊断效果不理想。
