Wu Yanping, Liao Siyu, Qu Tianyao, Zhou Jiaxuan, Dai Fei, Qin Bin, Xu Xiaoyu, Zhang Jun, Cheng Yan
Department of Gastroenterology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
PLoS One. 2025 Jan 17;20(1):e0316226. doi: 10.1371/journal.pone.0316226. eCollection 2025.
According to Rome IV, reflux hypersensitivity (RH) represents a novel form of functional esophageal disorder. This study was designed to compare the clinical features of three types of endoscopic-negative heartburn: RH, nonerosive reflux disease (NERD), and functional heartburn (FH).
Patients with heartburn in a medical center from 01/01/2017 to 10/31/2021 were included. This article presented a blinded retrospective analysis of 24 h MII-pH and HRM tracings from patients with NERD, RH, and FH to compare their clinical characteristics.
A total of 118 patients were included in the study. There were no significant differences in age, sex, BMI, smoking status, or drinking history among RH, NERD and FH. Functional dyspepsia (FD) symptoms were more prone to exist in FH than in NERD (P < 0.05), whereas hiatal hernia was more prevalent in NERD and RH than in FH (P < 0.05). The incidence of anxiety and depression gradually increased in the NERD, RH, and FH groups (P > 0.05). The distal MNBI and PSPW index of the NERD and RH groups were lower than those of the FH group (P < 0.05). The distal MNBI showed good diagnostic potential.
Clear pathological alterations, which are distinct from those of other FGIDs, are observable in RH. It might be inappropriate to categorize RHs within FGIDs.
根据罗马IV标准，反流高敏反应（RH）是一种新型的功能性食管疾病。本研究旨在比较三种内镜检查阴性的烧心类型的临床特征：RH、非糜烂性反流病（NERD）和功能性烧心（FH）。
纳入2017年1月1日至2021年10月31日在某医疗中心就诊的烧心患者。本文对NERD、RH和FH患者的24小时多通道腔内阻抗-pH监测（MII-pH）和高分辨率食管测压（HRM）记录进行了盲法回顾性分析，以比较它们的临床特征。
本研究共纳入118例患者。RH、NERD和FH患者在年龄、性别、体重指数、吸烟状况或饮酒史方面无显著差异。FH患者比NERD患者更容易出现功能性消化不良（FD）症状（P < 0.05），而食管裂孔疝在NERD和RH患者中比FH患者更常见（P < 0.05）。NERD、RH和FH组焦虑和抑郁的发生率逐渐升高（P > 0.05）。NERD和RH组的远端平均神经支配指数（MNBI）和收缩期峰压波宽（PSPW）指数低于FH组（P < 0.05）。远端MNBI具有良好的诊断潜力。
在RH中可观察到与其他功能性胃肠病不同的明确病理改变。将RH归类于功能性胃肠病可能不合适。
