Lam H G, Breumelhof R, Roelofs J M, Van Berge Henegouwen G P, Smout A J
Department of Gastroenterology, University Hospital Utrecht, The Netherlands.
Dig Dis Sci. 1994 Feb;39(2):402-9. doi: 10.1007/BF02090215.
Since noncardiac chest pain is the only well-established indication for 24-hr esophageal pH and pressure recording, the analysis of the association between chest pain episodes and esophageal motility abnormalities or reflux is the most important part of data analysis in 24-hr monitoring. Until now, different time windows have arbitrarily been used by various research groups. The aim of this study was to determine the optimal time window for symptom analysis in 24-hr esophageal pH and pressure monitoring. For this purpose repetitive symptom association analysis was carried out, using time windows of various onsets and durations. For each time window, the symptom indices for reflux and dysmotility were calculated. The symptom index for both reflux and dysmotility showed a gradual increase for windows with increasingly early onset, following a pattern that would be predicted on the basis of Poisson's theory. However, both indices had a relatively sharp cutoff point at 2 min before the onset of pain. Both indices only showed a predictable gradual increase when the time window starting at -2 min was extended beyond the moment of pain onset. It is concluded that the optimal time window for symptom analysis in 24-hr esophageal pH and pressure recording begins at 2 min before the onset of pain and ends at the onset of pain.
由于非心源性胸痛是24小时食管pH值和压力记录唯一已明确的适应证，胸痛发作与食管动力异常或反流之间关联的分析是24小时监测数据分析中最重要的部分。到目前为止，不同的研究小组随意使用了不同的时间窗。本研究的目的是确定24小时食管pH值和压力监测中症状分析的最佳时间窗。为此，使用不同起始时间和持续时间的时间窗进行了重复性症状关联分析。对于每个时间窗，计算反流和动力障碍的症状指数。反流和动力障碍的症状指数均显示，随着起始时间越来越早，指数逐渐增加，呈现出基于泊松理论可预测的模式。然而，两个指数在疼痛发作前2分钟都有一个相对明显的截断点。只有当从-2分钟开始的时间窗延长至疼痛发作时刻之后，两个指数才呈现出可预测的逐渐增加。得出的结论是，24小时食管pH值和压力记录中症状分析的最佳时间窗始于疼痛发作前2分钟，止于疼痛发作时刻。
