Normal Values of Pharyngeal and Esophageal 24-Hour pH Impedance in Individuals on and off Therapy and Interobserver Reproducibility
Normal Values of Pharyngeal and Esophageal 24-Hour pH Impedance in Individuals on and off Therapy and Interobserver Reproducibility
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DOI：
10.1016/j.cgh.2012.10.041
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发表时间：
2013-04-01
影响因子：
12.6
通讯作者：
Mion, Francois
中科院分区：
文献类型：
--
作者：
Zerbib, Frank;Roman, Sabine;Mion, Francois
背景与目的：pH和阻抗联合监测可以检测食管腔和咽部内所有类型的反流发作。我们进行了一项多中心研究，以确定治疗期间和治疗结束时个体的咽部和食道pH阻抗监测的正常值，并确定该技术的观察者间重现性。方法：我们使用分叉探针收集了46名健康受试者的动态24小时pH阻抗记录，该探针可以检测远端和近端食道和咽部的反流事件。当受试者未接受任何药物（停止治疗）和接受40 mg埃索美拉唑每日两次持续14天（治疗）后收集数据。在20例停止治疗和接受治疗的受试者中确定了观察者间检测反流事件的一致性。结果表示为中位数（四分位距）。结果：治疗结束后，受试者的食管远端返流事件中位数为32例（17 - 45），食管近端返流事件中位数为3例（1 - 6）;咽部无返流事件。在治疗期间，受试者远端食管发生反流事件的中位数为21例（6 - 37），近端食管为2例（0 - 5）;同样，咽部无反流事件。观察者之间的协议是良好的食管反流事件，但差咽events.CONCLUSIONS：我们确定了正常值的咽部和胃食管反流事件的受试者接受或不接受埃索美拉唑治疗的24小时pH阻抗监测。食管事件的分析是可重复的，但咽部事件的分析是不可重复的;在进一步的研究中应考虑到这一限制。Eudract.ema.europa.eu
BACKGROUND & AIMS: Combined pH and impedance monitoring can detect all types of reflux episodes within the esophageal lumen and the pharynx. We performed a multicenter study to establish normal values of pharyngeal and esophageal pH-impedance monitoring in individuals on and off therapy and to determine the interobserver reproducibility of this technique.METHODS: We collected ambulatory 24-hour pH-impedance recordings from 46 healthy subjects by using a bifurcated probe that allowed for detection of reflux events in the distal and proximal esophagus and pharynx. Data were collected when subjects had not received any medicine (off therapy) and after receiving 40 mg esomeprazole twice daily for 14 days (on therapy). The interobserver agreement for the detection of reflux events was determined in 20 subjects off and on therapy. Results were expressed as median (interquartile range).RESULTS: Off therapy, subjects had a median of 32 reflux events (17-45) in the distal esophagus and 3 (1-6) in the proximal esophagus; they had none in the pharynx. On therapy, subjects had a median number of 21 reflux events (6-37) in the distal esophagus and 2 (0-5) in the proximal esophagus; again, there were none in the pharynx. Interobserver agreement was good for esophageal reflux events but poor for pharyngeal events.CONCLUSIONS: We determined normal values of pharyngeal and gastroesophageal reflux events by 24-hour pH-impedance monitoring of subjects receiving or not receiving esomeprazole therapy. Analyses of esophageal events were reproducible, but analyses of pharyngeal events were not; this limitation should be taken into account in further studies. Eudract.ema.europa.eu, Number: 2010-022845-48.