Wang Shengyuan, Wen Siwan, Bai Xiao, Zhang Mengru, Zhu Yiqing, Wu Mingyan, Lu Lihua, Shi Cuiqin, Yu Li, Xu Xianghuai
Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, No. 389 Xincun Road, Shanghai 200065, China.
Ther Adv Chronic Dis. 2022 Aug 17;13:20406223221117455. doi: 10.1177/20406223221117455. eCollection 2022.
Multichannel intraluminal impedance and pH-monitoring (MII-pH) is an essential testing modality for gastroesophageal reflux-induced chronic cough (GERC), while the existing diagnostic criteria still have some inherent defects. This study aimed to explore the diagnostic value of a direct and objective index, reflux episodes, and related parameters in MII-pH in different types of GERC.
Patients with chronic cough suspected of gastroesophageal reflux disease who successfully received MII-pH were enrolled. The differences in MII-pH parameters were analyzed among patients with different etiologies and the predictive diagnostic value of reflux episodes and related parameters were analyzed in patients with GERC, acid GERC, and non-acid GERC, and compared with existing diagnostic criteria.
A total of 190 patients with suspected GERC who underwent MII-pH were enrolled; 131 of these patients were finally diagnosed with GERC. When the reflux episodes were used to diagnose GERC, the area under the curve (AUC) was 0.684; when the acid reflux episodes and the ratio of acid reflux episodes were used to diagnose acid GERC, the AUCs were 0.769 and 0.854; when the non-acid reflux episodes and the ratio of non-acid reflux episodes were used to diagnose non-acid GERC, the AUCs were 0.735 and 0.705, respectively. When the non-acid reflux episodes > 58 and the proportion of non-acid reflux episodes > 68.18% were used alone or in combination to diagnose non-acid GERC, their diagnostic value was significantly better than SAP or SI (all s < 0.05).
The number of reflux episodes has a good diagnostic value for GERC, especially in the diagnosis of non-acid GERC.
多通道腔内阻抗和pH监测（MII-pH）是诊断胃食管反流引起的慢性咳嗽（GERC）的重要检查方法，但现有诊断标准仍存在一些固有缺陷。本研究旨在探讨MII-pH中反流事件这一直接客观指标及其相关参数在不同类型GERC中的诊断价值。
纳入成功接受MII-pH检查的疑似胃食管反流病慢性咳嗽患者。分析不同病因患者的MII-pH参数差异，并分析反流事件及其相关参数对GERC、酸性GERC和非酸性GERC患者的预测诊断价值，并与现有诊断标准进行比较。
共纳入190例接受MII-pH检查的疑似GERC患者，其中131例最终确诊为GERC。以反流事件诊断GERC时，曲线下面积（AUC）为0.684；以酸反流事件及酸反流事件比例诊断酸性GERC时，AUC分别为0.769和0.854；以非酸反流事件及非酸反流事件比例诊断非酸性GERC时，AUC分别为0.735和0.705。单独或联合使用非酸反流事件>58次和非酸反流事件比例>68.18%诊断非酸性GERC时，其诊断价值显著优于SAP或SI（均P<0.05）。
反流事件次数对GERC具有良好的诊断价值，尤其在非酸性GERC的诊断中。
