Pop Radu Samuel, Chiperi Lăcrămioara Eliza, Nechita Vlad-Ionuț, Man Sorin Claudiu, Dumitrașcu Dan Lucian
3rd Department of Pediatrics, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400217 Cluj-Napoca, Romania.
Department of Pediatrics, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540136 Târgu Mureș, Romania.
Clin Pract. 2024 Aug 27;14(5):1682-1695. doi: 10.3390/clinpract14050134.
(1) Background: Multichannel intraluminal impedance-pH (MII-pH) monitoring is commonly used to diagnose gastroesophageal reflux disease (GERD). The mean nocturnal baseline impedance (MNBI) is an important parameter, reflecting the esophageal mucosal integrity and improvement in GERD. This study aims to evaluate the correlation between conventionally measured MNBI and a recently described simple MNBI measurement method in diagnosing pediatric GERD. (2) Methods: This prospective observational study enrolled 64 children aged one month to 18 years who underwent 24 h MII-pH monitoring. Conventional MNBI was measured during stable 10 min intervals at night, while the simple MNBI method averaged impedance throughout the nocturnal supine period. (3) Results: Strong correlations were found between conventional and simple MNBI values across all impedance channels in both infants (r > 0.85) and older children (r > 0.9). Conventional and simple MNBIs in the most distal channel (Z6) effectively differentiated non-erosive reflux disease (NERD) from other phenotypes, with AUCs of 0.864 and 0.860, respectively. The simple MNBI demonstrated good diagnostic performance with similar sensitivity and specificity to the conventional MNBI. (4) Conclusions: Including MNBI measurements into routine MII-pH monitoring may enhance GERD diagnosis and reduce the need for more invasive procedures.
（1）背景：多通道腔内阻抗-pH（MII-pH）监测常用于诊断胃食管反流病（GERD）。夜间平均基线阻抗（MNBI）是一个重要参数，反映食管黏膜完整性及GERD的改善情况。本研究旨在评估传统测量的MNBI与最近描述的一种简单MNBI测量方法在诊断小儿GERD中的相关性。（2）方法：这项前瞻性观察性研究纳入了64名年龄在1个月至18岁之间接受24小时MII-pH监测的儿童。传统MNBI在夜间稳定的10分钟间隔内测量，而简单MNBI方法是在夜间仰卧期对阻抗进行平均计算。（3）结果：在婴儿（r>0.85）和大龄儿童（r>0.9）的所有阻抗通道中，传统MNBI值与简单MNBI值之间均发现有很强的相关性。最远端通道（Z6）的传统MNBI和简单MNBI能有效区分非糜烂性反流病（NERD）与其他表型，曲线下面积（AUC）分别为0.864和0.860。简单MNBI表现出良好的诊断性能，其敏感性和特异性与传统MNBI相似。（4）结论：将MNBI测量纳入常规MII-pH监测可能会提高GERD的诊断率，并减少对侵入性更强的检查的需求。
