Wu Yanhong, Guo Zihao, Zhang Chuan, Zhan Yutao
Department of Gastroenterology, Beijing Tong Ren Hospital, Capital Medical University, Beijing, P. R. China.
Department of Gastroenterology, Beijing Tong Ren Hospital, Capital Medical University, No.1, Dongjiaominxiang, Dongcheng District, Beijing 100730, P. R. China.
Therap Adv Gastroenterol. 2022 Aug 11;15:17562848221105195. doi: 10.1177/17562848221105195. eCollection 2022.
Gastroesophageal reflux disease (GERD) is a common disease with increasing prevalence worldwide. However, the diagnosis of GERD is challenging because there are no definite gold standard criteria. Recently, a novel impedance parameter, namely mean nocturnal baseline impedance (MNBI), has been proposed, which reflects the burden of longitudinal reflux and the integrity of esophageal mucosa. MNBI has shown an immense promise for increasing the diagnostic rate of multichannel intraluminal impedance-pH (MII-pH) monitoring and predicting the response to proton pump inhibitor (PPI) or anti-reflux intervention in patients with reflux symptoms. The present paper reviews the association between baseline impedance and esophageal mucosal integrity, the acquisition of MNBI in 24-h MII-pH monitoring, the clinical utilization of MNBI in improving the diagnosis rate of GERD in patients with typical reflux symptoms, predicting the response to PPI or anti-reflux treatment in these patients, the utilization of MNBI in diagnosing patients with atypical symptoms or extra-esophageal symptoms, and the correlation between reflux burden and MNBI. MNBI should be routinely assessed using MII-pH monitoring.
胃食管反流病（GERD）是一种常见疾病，在全球范围内的患病率呈上升趋势。然而，GERD的诊断具有挑战性，因为没有明确的金标准。最近，一种新的阻抗参数，即平均夜间基线阻抗（MNBI）被提出，它反映了纵向反流的负担和食管黏膜的完整性。MNBI在提高多通道腔内阻抗-pH（MII-pH）监测的诊断率以及预测反流症状患者对质子泵抑制剂（PPI）或抗反流干预的反应方面显示出巨大的前景。本文综述了基线阻抗与食管黏膜完整性之间的关联、24小时MII-pH监测中MNBI的获取、MNBI在提高典型反流症状患者GERD诊断率方面的临床应用、预测这些患者对PPI或抗反流治疗的反应、MNBI在诊断非典型症状或食管外症状患者中的应用以及反流负担与MNBI之间的相关性。应使用MII-pH监测对MNBI进行常规评估。
