Computerized identification of pathologic duodenogastric reflux using 24-hour gastric pH monitoring.
Computerized identification of pathologic duodenogastric reflux using 24-hour gastric pH monitoring.
复制标题
使用 24 小时胃 pH 监测对病理性十二指肠胃反流进行计算机识别。
DOI：
10.1097/00000658-199101000-00003
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发表时间：
1991
影响因子：
9
通讯作者：
Gupta,NC
中科院分区：
文献类型：
--
作者：
Fuchs,KH;DeMeester,TR;Hinder,RA;Stein,HJ;Barlow,AP;Gupta,NC
十二指肠胃反流是一种自然发生的偶发事件，其发生率、发生率和有害影响一直难以评估。研究了24小时胃pH监测检测十二指肠胃反流的可靠性。为此目的使用 pH 监测的核心是对其测量和显示 pH 数据的能力充满信心，这种数据能够以足够的灵敏度反映胃 pH 环境的变化。为了测试这一点，测量了 10 只狗在禁食状态、喂食后和五肽胃泌素刺激后的胃部 pH 值。空腹状态下胃窦呈碱性（p 小于 0.01），并且通过频率分布图显示的数据足够灵敏，足以反映引起的 pH 变化。为了测试给定位置胃部 pH 值的一致性，对 12 名正常受试者进行同时 24 小时胃部监测，将两个探针放置在食管下括约肌下方 5 或 10 cm 处。仅在 5 厘米位置处，两个探针在 90% 以上的情况下读取的读数都在 1 pH 单位以内。基于这些原则，对30名正常受试者和11名患者下食管括约肌下方5 cm处进行了胃部pH监测，符合Ritchie病理性十二指肠胃反流的临床标准。获得的数据被排列成 71 个变量并进行判别分析。确定了十六个变量，每个变量都有一个相应的系数，用作乘数来得出分数。评分超过+2.2表明病理性十二指肠胃反流的可能性很高。该测试应用于由 10 名额外正常受试者和 10 名符合 Ritchie 标准的患者组成的验证群体。所有正常受试者的评分均正常，除一名（90%）患者外，所有患者评分均异常。与另一组 22 名正常受试者和 60 名患者的 O-二异丙基亚氨基二乙酸 (DISIDA) 闪烁扫描相比，24 小时胃 pH 监测在检测病理性十二指肠胃反流方面更有效。该研究展示了如何应用计算机技术来诊断具有复杂前肠症状的患者的病理性十二指肠胃反流。
Duodenogastric reflux is a naturally occurring sporadic event, the incidence, occurrence, and detrimental effects of which have been difficult to assess. The reliability of 24-hour gastric pH monitoring to detect duodenogastric reflux was studied. Central to the use of pH monitoring for this purpose is confidence in its ability to measure and display pH data in a way that reflects changes in the gastric pH environment with sufficient sensitivity. To test this the gastric pH of 10 dogs was measured in the fasting state, after feeding, and after pentagastrin stimulation. The antrum was more alkaline in the fasting state (p less than 0.01) and the display of data by frequency distribution graph was sensitive enough to reflect induced pH changes. To test the consistency of gastric pH at a given position, simultaneous 24-hour gastric monitoring was performed in 12 normal subjects with two probes placed at either 5 or 10 cm below the lower esophageal sphincter. Only at the 5-cm position did the two probes read within 1 pH unit of each other more than 90% of the time. Based on these principles, gastric pH monitoring was performed 5 cm below the lower esophageal sphincter in 30 normal subjects and 11 patients, fulfilling Ritchie's clinical criteria for pathologic duodenogastric reflux. The data obtained was arranged into 71 variables and subjected to discriminant analysis. Sixteen variables were identified, each with a corresponding coefficient to be used as a multiplier to derive a score. A score of more than +2.2 indicated a high probability of pathologic duodenogastric reflux. The test was applied to a validation population consisting of 10 additional normal subjects and 10 patients meeting Ritchie's criteria. All normal subjects had a normal score and all but one (90%) of the patients had an abnormal score. When compared to O-diisopropyl iminodiacetic acid (DISIDA) scintigraphy in another group of 22 normal subjects and 60 patients, 24-hour gastric pH monitoring was superior in the detection of pathologic duodenogastric reflux. The study shows how the application of computer technology can be used to diagnose pathologic duodenogastric reflux in patients with complex foregut complaints.