Department of Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
University of Notre Dame, Sydney, New South Wales, Australia.
J Dig Dis. 2021 Jul;22(7):419-424. doi: 10.1111/1751-2980.13024. Epub 2021 Jun 21.
OBJECTIVES: Mean nocturnal baseline impedance (MNBI) shows promise in investigating reflux disease by reflecting esophageal mucosal integrity. This study aimed to measure MNBI by both conventional and simple methods in patients with laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) in order to evaluate the efficacy of the simple measurement method. METHODS: Altogether 187 patients were divided into LPR (n = 105) or GERD (n = 82) groups according to their predominant symptom profile, and underwent off-therapy impedance-pH monitoring. MNBI was measured by both the conventional and simple methods. The Bland-Altman plots were constructed to assess mean differences and to identify bias in the two measurement methods. RESULTS: For the two measurement methods, mean difference was (-89 ± 328) Ω in the distal esophagus, (-6 ± 653) Ω in the proximal esophagus, and (128 ± 577) Ω in the pharynx, respectively. There was a strong correlation between conventional and simple MNBI values, with the coefficient of 0.940 in the distal esophagus, 0.463 in the proximal esophagus, and 0.712 in the pharynx (all P < 0.001). CONCLUSIONS: There was an excellent agreement between the conventional and simple methods of MNBI measurement, with no evidence of proportional bias. Conventional and simple MNBI values correlated excellently in the distal esophagus and moderately well in the proximal esophagus and pharynx. This study supports the use of the simple method of measuring MNBI to enhance diagnoses of reflux disease.
目的:平均夜间基础阻抗(MNBI)通过反映食管黏膜完整性,有望用于胃食管反流病(GERD)的研究。本研究旨在通过常规和简单方法测量 LPR 和 GERD 患者的 MNBI,以评估简单测量方法的疗效。
方法:根据主要症状谱将 187 例患者分为 LPR(n=105)或 GERD(n=82)组,并进行停药后阻抗-pH 监测。通过常规和简单方法测量 MNBI。构建 Bland-Altman 图以评估两种测量方法的均值差异和偏差。
结果:对于两种测量方法,远端食管的平均差值为(-89±328)Ω,近端食管为(-6±653)Ω,咽部为(128±577)Ω。常规和简单 MNBI 值之间具有很强的相关性,远端食管的相关系数为 0.940,近端食管为 0.463,咽部为 0.712(均 P<0.001)。
结论:MNBI 常规测量法和简单测量法之间具有极好的一致性,无比例偏差的证据。在远端食管中,常规和简单 MNBI 值相关性极好,在近端食管和咽部中度相关。本研究支持使用简单的 MNBI 测量方法来增强对反流病的诊断。
J Gastroenterol Hepatol. 2020-2-11