Oropharyngeal pH Monitoring for the Detection of Liquid and Aerosolized Supraesophageal Gastric Reflux
Oropharyngeal pH Monitoring for the Detection of Liquid and Aerosolized Supraesophageal Gastric Reflux
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DOI：
10.1016/j.jvoice.2007.12.005
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发表时间：
2009-07-01
期刊：
影响因子：
2.2
通讯作者：
Vaezi, Michael
中科院分区：
文献类型：
--
作者：
Wiener, Gregory J.;Tsukashima, Ross;Vaezi, Michael
胃食道反流病(GERD)和食管外症状之间的联系尚不清楚，也很难证明。由于缺乏诊断敏感性，这组患者的PH值监测导致了相互矛盾的数据。最近，一种新的用于检测口咽部液体和气雾化液滴的灵敏pH装置(Dx-pH测量系统[Dx-pH])已经问世。我们的假设是，使用这种设备，我们将能够提高我们识别和理解这群患者的能力。这项初步观察研究的目的是将这种新设备与标准的食道和咽部pH探头在一小部分有食道外症状的患者中的结果进行比较。怀疑有食道外GER症状的患者接受了传统的24小时食道-咽部pH监测(24pH)，同时进行了口咽Dx-pH监测。为了比较和关联两种探针，对示踪进行了审查，Dx-pH探针中的事件被定义为与基线的快速下降>；3标准偏差。15例患者(女性10例，男性5例)，年龄25~75岁，平均57.5岁。主要主诉包括12/15慢性咳嗽，2/15哮喘，1/15清喉。所有Dx-pH事件均发生在食道远端pH下降之前，并与之相关。Dx-pH监测有10例患者出现1~13次口咽pH异常事件，共48次。反流事件的中位数pH从食道远端探头的3.1上升到咽部的5.2和口咽部的5.6，后者比远端食道探头高80%(P10%)。它们很可能不能用标准的pH标准来识别
The association between gastroesophageal reflux disease (GERD) and extraesophageal symptoms is poorly understood and difficult to document. pH monitoring in this group of patients has resulted in conflicting data due to lack of diagnostic sensitivity. Recently, a new sensitive pH device for detection of liquid and aerosolized droplets in the oropharynx (The Dx-pH Measurement System [Dx-pH]) has become available. Our hypothesis is that we will be able to improve our ability to identify and understand this group of patients with this device. The aim of this preliminary observation study was to compare the results of this new device to the standard esophageal and pharyngeal pH probes in a small group of patients with extraesophageal symptoms. Patients with suspected extraesophageal GER symptoms underwent traditional 24-hour esophago-pharyngeal pH monitoring (24pH) simultaneous with Dx-pH monitoring in the oropharynx. Tracings were reviewed for comparison and correlation between the two probes, with an event in the Dx-pH Probe being defined as a rapid drop >3 standard deviation from baseline. Fifteen patients (10 females, 5 males) with mean age of 57.5 years (range, 25-75) were studied. The predominant chief complaint included 12/15 chronic cough, 2/15 asthma; and 1/15 throat clearing. All Dx-pH events were preceded and associated with distal esophageal pH drops in a progressive ante grade manner. Ten patients had 1-13 abnormal oropharyngeal pH events as measured by Dx-pH monitoring, with a total of 48 events. The median pH of reflux events had a statistically significant increase from 3.1 at the distal esophageal probe to 5.2 at the pharynx and 5.6 at the oropharynx, the latter being 80% higher than the distal esophageal probe (P10%). which are likely not to be identified using the standard criteria of pH