DeMeester T R, Wang C I, Wernly J A, Pellegrini C A, Little A G, Klementschitsch P, Bermudez G, Johnson L F, Skinner D B
J Thorac Cardiovasc Surg. 1980 May;79(5):656-70.
The technique of 24 hour esophageal pH monitoring (24 hour pH test) is described. Experience with the 24 hour pH test in 393 patients with suspected esophageal disease has shown the clinical usefulness of the test in objectively determining the presence of gastroesophageal reflux. The test was effective in evaluating atypical symptoms of gastroesophageal reflux such as respiratory symptoms and chest pain and, in children, failure to thrive and recurrent pneumonia. The 24 hour pH test was particularly useful in evaluating patients who were referred with other abdominal or thoracic disease and had, in addition, symptoms suggestive of gastroesophageal reflux on history. The test helped to unsnarl the cause of recurrent symptoms after an esophageal myotomy for achalasia or an antireflux procedure. Of 179 patients with typical symptoms of gastroesophageal reflux, 27% had normal 24 hour test results and were subsequently diagnosed as having another cause for their symptoms. Of 146 patients who had normal findings on esophagoscopy, 54% were shown to have abnormal gastroesophageal reflux on 24 hour pH monitoring, indicating lack of sensitivity of endoscopy to detect reflux. In addition, the 24 hour pH test identified patterns of abnormal reflux and indicated those patients most at risk for development of stricture. The test is well tolerated by the patients, simple to use, and dependable when performed and read as described. The clinical use of the 24 hour pH test brings objectivity to the evaluation of exophageal disease that has hitherto not been available.
本文描述了24小时食管pH监测技术（24小时pH测试）。对393例疑似食管疾病患者进行24小时pH测试的经验表明，该测试在客观确定胃食管反流的存在方面具有临床实用性。该测试在评估胃食管反流的非典型症状（如呼吸道症状和胸痛）以及儿童的生长发育不良和反复肺炎方面有效。24小时pH测试在评估因其他腹部或胸部疾病转诊且病史提示有胃食管反流症状的患者时特别有用。该测试有助于明确贲门失弛缓症食管肌切开术或抗反流手术后反复出现症状的原因。在179例有典型胃食管反流症状的患者中，27%的患者24小时测试结果正常，随后被诊断为有其他导致其症状的原因。在146例食管镜检查结果正常的患者中，54%在24小时pH监测中显示有异常胃食管反流，表明内镜检查检测反流缺乏敏感性。此外，24小时pH测试可识别异常反流模式，并指出那些发生狭窄风险最高的患者。该测试患者耐受性良好，使用简单，按所述方法进行操作和解读时可靠。24小时pH测试的临床应用为食管疾病的评估带来了迄今为止尚未具备的客观性。
