Combined Dual Channel Impedance/pH-metry in Patients With Suspected Laryngopharyngeal Reflux.
Combined Dual Channel Impedance/pH-metry in Patients With Suspected Laryngopharyngeal Reflux.
复制标题
DOI：
10.5056/jnm.2010.16.2.157
复制
发表时间：
2010-04
影响因子：
3.4
通讯作者：
Song GA
中科院分区：
文献类型：
--
作者：
Lee BE;Kim GH;Ryu DY;Kim DU;Cheong JH;Lee DG;Song GA
胃食管反流病 (GERD) 的喉咽部症状，如球感、声音嘶哑和慢性咳嗽，越来越受到人们的重视。本研究旨在探讨双通道多通道腔内阻抗 (MII)/pH 测量相结合对疑似喉咽反流的“脱质子泵抑制剂 (PPI)”患者的诊断有用性。纳入了 98 名具有 GERD 咽喉症状的患者。所有患者在研究前至少两周处于“关闭 PPI”状态，并接受内窥镜检查和双通道组合 MII/pH 测定。患者的平均年龄为 49.8 ± 10.9 岁，其中男性 44 例（44.9%）。 53 名患者 (54.1%) 表现出病理性胃食管反流 (GER)。双通道 MII/pH 测量组合的诊断率最高为 49.0%，单通道 MII/pH 测量组合的诊断率为 37.8%。将 MII 添加到标准 pH 测定法中，检测 GER 的诊断率增加了一倍。在通过 MII/pH 测定法检测到病理性 GER 的 37 名患者（37.8%）中，19 名患者（19.4%）为非酸性 GER（非酸性 GER 组），而 18 名患者（18.4%）为酸性 GER（酸性 GER 组）。根据 MII/pH 测量法分类，病理性 GER 组比非病理性 GER 组表现出更频繁的癔球感觉。酸性 GER 组比非酸性 GER 组有更多的近端反流，尤其是在直立位时。在本研究中，组合双通道 MII/pH 测定法显示出检测 GER 的最高诊断率。该技术主要用于准确诊断咽喉反流病并排除咽喉症状的其他原因。
Laryngopharyngeal symptoms of gastroesophageal reflux disease (GERD) such as globus sensation, hoarseness and chronic cough are becoming increasingly recognized. This study was aimed to investigate the diagnostic usefulness of combined dual channel multichannel intraluminal impedance (MII)/pH-metry in 'off-proton pump inhibitor (PPI)' patients with suspected laryngopharyngeal reflux. Ninety-eight patients with laryngopharyngeal symptoms of GERD were included. All patients were 'off-PPI' state for at least 2 weeks prior to the study, and underwent endoscopy and dual channel combined MII/pH-metry. The mean age of the patients was 49.8 ± 10.9 years and there were 44 males (44.9%). Fifty-three patients (54.1%) showed pathologic gastroesophageal reflux (GER). Combined dual channel MII/pH-metry achieved highest diagnostic yield of 49.0% and diagnostic yield of single channel combined MII/pH-metry was 37.8%. Addition of MII to standard pH-metry increased twofold of the diagnostic yield for detecting GER. Among 37 patients (37.8%) who had pathologic GER being detected by MII/pH-metry, 19 patients (19.4%) had nonacid GER (nonacid GER group) while 18 patients (18.4%) had acid GER (acid GER group). Pathologic GER group, as classified by MII/pH-metry showed more frequent globus sensation than nonpathologic GER group. Acid GER group had more proximal reflux than nonacid GER group, especially in the upright position. In this study, combined dual channel MII/pH-metry showed the highest diagnostic yield for detecting GER. This technique can be performed primarily to accurately diagnose laryngopharyngeal reflux disease and exclude other causes of laryngopharyngeal symptoms.