Department of Digestive Diseases, Campus Bio Medico University of Rome, Roma, Italy.
Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy.
Am J Gastroenterol. 2024 Jan 1;119(1):206-209. doi: 10.14309/ajg.0000000000002491. Epub 2023 Sep 1.
Gastroesophageal reflux disease (GERD) severity increases with esophageal body hypomotility, but the impact of Chicago Classification (CC) v4.0 criteria on GERD diagnosis is incompletely understood.
In patients with GERD evaluated with high-resolution manometry and pH-impedance monitoring, CCv3.0 and CCv4.0 diagnoses were compared.
In 247 patients, hypomotility diagnosis decreased from 45.3% (CCv3.0) to 30.0% (CCv4.0, P < 0.001). In contrast, within patients with ineffective esophageal motility, proportions with pathological acid exposure increased from 38% (CCv3.0) to 88% (CCv4.0); baseline impedance and esophageal clearance demonstrated similar findings ( P < 0.05 for each comparison).
CCv4.0 hypomotility criteria are more specific in supporting GERD evidence compared with CCv3.0.
胃食管反流病（GERD）的严重程度随着食管体动力不足而增加，但芝加哥分类（CC）v4.0 标准对 GERD 诊断的影响尚不完全清楚。
在接受高分辨率测压和 pH 阻抗监测评估的 GERD 患者中，比较了 CCv3.0 和 CCv4.0 诊断。
在 247 例患者中，运动障碍的诊断率从 45.3%（CCv3.0）降至 30.0%（CCv4.0，P<0.001）。相比之下，在无效食管动力的患者中，病理性酸暴露的比例从 38%（CCv3.0）增加到 88%（CCv4.0）；基线阻抗和食管清除率也有类似发现（每项比较均 P<0.05）。
与 CCv3.0 相比，CCv4.0 运动障碍标准更能支持 GERD 的证据。
