Acid Exposure Time > 6% Might Not Improve the Therapeutic Outcome in Chinese Gastroesophageal Reflux Disease Patients.
Acid Exposure Time > 6% Might Not Improve the Therapeutic Outcome in Chinese Gastroesophageal Reflux Disease Patients.
复制标题
DOI：
10.5056/jnm19219
复制
发表时间：
2021-01-30
影响因子：
3.4
通讯作者：
Xiao Y
中科院分区：
文献类型：
--
作者：
Lin Y;Li Y;Liang M;Tan N;Zhang M;Chen S;Xiao Y
中国人胃食道反流病(GERD)患者的酸负荷较低。然而，里昂共识提出了GERD更高的酸暴露时间阈值(AET>；6%)。其目的是在中国GERD患者中应用最新的标准，并阐明其对临床结果的影响。对因反流症状而同时接受食道高分辨率测压和24小时食道pH监测的患者进行了回顾性筛查。AET>；4%的患者包括在内，并被分为AET 4-6%或AET>；6%。评估了它们的压强分布、回流分布和对质子泵抑制剂(PPI)的响应。在里昂共识中提出的附加证据被添加到AET4-6%的患者中以获得治疗收益。另一组患者(n=144)合并AET<；4%为非GERD患者。总共包括151名患者(102名男性)，其中113名患者AET和GT；6%(74.9%)。与非GERD患者相比，患有AET>；4%的GERD患者男性更多、年龄更大、体重指数更高。同时，GERD患者对食管胃交界处压力的控制能力较差。然而，AET>；6%和4-6%患者的压力和反流曲线相似。AET+GT；6%组和4~6%组PPI治疗有效率分别为64.6%和63.2%(P>；0.05)。当在AET4-6%的患者中添加辅助证据时，没有获得治疗收益。在AET和GT；6%和4-6%的患者中，PPI治疗的疗效相似。AET阈值的提高并不影响中国GERD患者的临床结局。
There is less acid burden in Chinese gastroesophageal reflux disease (GERD) patients. However, the Lyon consensus proposed a higher threshold of acid exposure time (AET > 6%) for GERD. The aims are to apply the updated criteria in Chinese GERD patients and clarify its influence on clinical outcome. Patients who were referred for both esophageal high-resolution manometry and 24-hour esophageal pH monitoring due to reflux symptoms were retrospectively screened. Those patients with AET > 4% was included and grouped into either AET 4-6% or AET > 6%. Their manometric profile, reflux profile, and response to proton pump inhibitors (PPIs) were evaluated. Adjunctive evidence proposed in the Lyon consensus was added in patients with AET 4-6% for therapeutic gain. Another group of patients (n = 144) with AET < 4% were included as non-GERD patients. In total, 151 patients (102 males) were included with 113 patients AET > 6% (74.9%). GERD patients with AET > 4% were with more male, older patients, and higher body mass index compared with non-GERD patients. Meanwhile, GERD patients were less competent in esophagogastric junction pressure. However, the manometric and reflux profile were similar between patients with AET > 6% and 4-6%. The response rate of PPI therapy was 64.6% and 63.2%, respectively, in groups of AET > 6% and 4-6% (P > 0.05). When adjunctive evidence was added in patients with AET 4-6%, no therapeutic gain was obtained. The efficacy of PPI therapy was similar in patients with AET > 6% and 4-6%. The increase of the AET threshold did not influence the clinical outcome of Chinese GERD patients.
登录
查看更多内容
影响因子：
3.5
作者：
Carlson DA;Kathpalia P;Craft J;Tye M;Lin Z;Kahrilas PJ;Pandolfino JE
通讯作者：
Pandolfino JE
影响因子：
24.5
作者：
Lundell, LR;Dent, J;Wallin, L
通讯作者：
Wallin, L
影响因子：
7.6
作者：
Patel A;Wang D;Sainani N;Sayuk GS;Gyawali CP
通讯作者：
Gyawali CP
影响因子：
3.5
作者：
Roman S;Keefer L;Imam H;Korrapati P;Mogni B;Eident K;Friesen L;Kahrilas PJ;Martinovich Z;Pandolfino JE
通讯作者：
Pandolfino JE
影响因子：
4.5
作者：
Wang, An Jiang;Wang, He;Zhu, Xuan
通讯作者：
Zhu, Xuan