24小时食管pH值测定用于胃食管反流性咳嗽52例分析

目的:总结分析24 h食管pH值测定对胃食管反流性咳嗽的诊断价值。方法:对83例慢性咳嗽患者进行24 h食管pH值测定检查。结果:83例慢性咳嗽患者中,有52例诊断为胃食管反流性咳嗽。结论:24 h食管pH值测定对慢性咳嗽病因诊断具有重要意义。     

动态监测胃食管反流患者食管24 h pH值及压力

目的 探讨胃食管反流（ＧＥＲ）的食管酸暴露与动力学改变特征。     

24小时食管pH监测新生儿胃食管反流

对 １２例疑诊为胃食管反流（ＧＥＲ）的新生儿进行 ２４ ｈ食管内ｐＨ监测，６例无症状新生儿作对照，结果提示７例为生理性反流，５例为病理性反流，与钡餐诊断极不一致。认为利用钡餐检查诊断新生儿ＧＥＲ应慎重，２４ｈ食管内ｐＨ监测是诊断新生儿ＧＥＲ的较理想检查方法，并阐述了建立我国新生儿食管内ｐＨ监测正常值范围的必要性。     

食管24小时pH值监测45例分析

食管24h pH值监测是检测食管酸碱度的一个定量指标,被认为是诊断胃食管反流性疾病(GERD)的金标准。现将我院检查的45例作一总结。1 材料与方法1.1 研究对象1.1.1 正常对照组:15例,其中男6例,女9例,年龄22～74岁,平均45.1岁,无胃食管反流(GER)症状,经胃肠钡餐或胃镜检查无食管病变及活动性消     

非心原性胸痛患者24小时食管pH值监测

近年来，食管原性胸痛逐渐受到重视。但常规体格检查和内镜检查难以确定是胃食管返流病还是功能性消化不良。本研究对７９例以胸痛，烧心或伴有返酸、反胃等表现的患者同时进行２４小时食管ｐＨ值监测和内镜检查，并将两者结果作对照分析。１对象和方法１．１对象：胸痛经...     

24 h双通道食管pH监测对胃食管酸反流的监测意义

目的：探讨24 h双通道食管pH监测对胃食管病理性酸反流的监测意义。方法收集2011年8月-2012年9月因胃食管反流相关症状在我院消化科胃肠动力室行动态24 h双通道食管pH监测的51例患者资料,根据24 h双通道食管pH监测结果分为：远端、近端均有病理性酸反流组(20例),仅远端有病理性酸反流组(2例),仅近端有病理性酸反流组(9例),远端、近端均无病理性酸反流组(20例)。比较单、双通道24 h食管pH监测食管病理性酸反流阳性率的差异,分析仅近端食管出现病理性酸反流的可能原因及近端与远端食管酸反流的相关性。结果51例中9例仅近端提示有病理性酸反流,其中8例同时在本院进行了胃镜和(或)高分辨率食管测压检查,1例为Barrett食管(主诉仅为咽部异物感,没有明显的反酸、烧心症状),7例主诉反酸、烧心者中2例食管裂孔疝、2例贲门失迟缓、1例十二指肠球部溃疡和1例胡桃夹食管,另外1例胃镜结果阴性(未做高分辨率食管测压检查)。近端、远端均有病理性酸反流患者近端食管pH＜4所占总监测时间的百分比、卧位pH＜4所占百分比、立位pH＜4所占百分比及Demeester记分均明显高于单纯近端食管病理性酸反流患者(P＜0.05),最长酸反流时间的差异无统计学意义(P＞0.05)。食管近端、远端酸反流均与年龄有关,年龄越大越易反流。结论24 h双通道食管pH监测对有明显胃食管反流症状但pH监测远端食管无病理性酸反流的患者有一定诊断意义。喉咽反流与胃食管反流具有相关性,24 h双通道食管pH监测对其研究有帮助。     

胃食管反流性咳嗽患者24h食管pH值监测的临床意义

目的分析胃食管反流性咳嗽（GERC）患者使用奥美拉唑治疗前后食管pH值的变化,探讨24h食管动态pH值监测的临床意义。方法2007年2月至2008年4月对我院20例食管GERC患者（治疗组）,采用奥美拉唑治疗（40mg／d,晚上顿服,连服8周）。治疗前后动态监测其24h食管pH值,采用Johson和Demeester6种参数指标进行评价,进行治疗前后比较,并与文献报道正常对照组进行比较。结果治疗组患者pH〈4的总时间百分比、立位pH〈4的总时间百分比、卧位pH〈4的总时间百分比、pH〈4的反流次数、反流持续〉5min次数、最长反流时间（min）分别为13．5±8．5,12．2±4．0,15．8±4．1,56±13,4．15±1．87,26．2±16．5,治疗后分别为2．7±1．3,3．9±1．9,1．9±1．0,18±11,1．24±0．65,7．4±2．1。经配对t检验差异有统计学意义（P〈0．01）。治疗前后各参数诊断阳性率采用配对资料x^2检验差异有统计学意义（P〈0．01）。结论24h食管pH值的监测显示,奥美拉唑治疗能降低食管pH值,从而有效地治疗GERC。     

24小时食管pH监测新生儿胃食管反流

对１２例疑诊为胃食管反流的新生儿进行２４ｈ食管内ＰＨ监测，６例无症状新生儿作对照，结果提示７例为生理性反流，５例为理性反注，与钡餐诊断极不一致。认为利用钡餐检查诊断新生儿ＧＥＲ应慎重，２４ｈ食管内ＰＨ监测是诊断 新生儿ＧＥＲ的较理想检查方法，并阐述了建立了我国新生儿食管内ＰＨ监测正常值范围的必要性。     

Diagnosis of gastroesophageal reflux disease in elderly subjects using 24-hour esophageal pH monitoring

ＯｂｊｅｃｔｉｖｅＴｏｅｖａｌｕａｔｅｔｈｅｒｅｌａｔｉｏｎｓｈｉｐｂｅｔｗｅｅｎｔｈｅｐａｒａｍｅｔｅｒｓｏｆ２４ｈｏｕｒｅｓｏｐｈａｇｅａｌｐＨｍｏｎｉｔｏｒｉｎｇａｎｄｇａｓｔｒｏｅｓｏｐｈａｇｅａｌｒｅｆｌｕｘｄｉｓｅａｓｅ（ＧＥＲＤ）ａｍ...     

和胃降逆法对反流性食管炎患者24h食管pH的影响*

[目的] 观察应用和胃降逆法治疗反流性食管炎,24h食管pH监测的变化情况.[方法] 将60例反流性食管炎(RE)患者随机分为对照组(30例)和治疗组(30例),对照组给予西医治疗,治疗组给予中医和胃降逆法治疗,分别观察两组治疗前后24 h食管pH监测的变化情况.[结果] 在减低食管黏膜24h pH＜4总次数、pH＜4总时间、pH＜4百分时间以及Demeester积分等方面,西医治疗与中医和胃降逆法对于反流性食管炎患者的作用相当;中医和胃降逆法对于食管黏膜24 h最长反流持续时间的减低较西医治疗更为显著,西医治疗对于反流时间持续≥5 min次数的减低较中医和胃降逆法更为显著.[结论] 和胃降逆法能够有效降低食管pH值,治疗反流性食管炎疗效确切.     

胃食管反流性咳嗽的诱导痰细胞及介质特征分析

目的探讨胃食管反流性咳嗽(gastro-esophageal reflux induced cough,GERC)的气道炎症特点。方法根据Irwin’s解剖学诊断程序结合诱导痰方法,筛选出20例GERC患者(GERC组),并以10例健康人(健康对照组)和8例其他病因的咳嗽伴有胃食管反流(GER)患者(GER组)分别作对照组。HE染色分析痰液中细胞分类,分别采用荧光酶免疫法、酶联免疫吸附法测定诱导痰上清液中总IgE、嗜酸细胞阳离子蛋白(ECP)及白细胞介素8(IL-8)的浓度。结果GERC患者中性粒细胞百分率为(63.43±30.89)%较健康对照组(35.53±20.19)%明显增高(P<0.01);巨噬细胞百分率为(32.50±31.02)%较健康对照组(62.91±20.51)%明显降低(P<0.01);而嗜酸细胞百分率为(0.19±0.33)%和淋巴细胞百分率(4.88±10.39)%与健康对照组相比差异无显著性。除嗜酸细胞外,GERC和GERD组的诱导痰细胞总数及细胞学分类指标差异无统计学意义(P>0.05)。GERC组患者诱导痰上清液中IgE,ECP,IL-8的浓度分别为[(3.21±3.26)、(29.28±57.46)、(6.63±5.41)mg/L]与健康对照组[(2.48±0.52)、(8.02±8.39)、(7.02±10.79)mg/L]相比,差异无显著性。结论GERC患者气道存在明显的中性粒细胞性炎症。     

24小时食管胃PH监测的临床应用

测定３２例受试者２４ｈ食管ｐＨ节律变化，证实胃食管反流病患者与对照组比较，酸反流得分及其他酸反流指标均有明显不同。５例仅有食管反流症状，胃镜检查无食管炎的患者，经食管ＰＨ检测酸反流得分异常，确诊为胃食管反流病。提示食管ＰＨ监测对诊断胃食管反流病具敏感性高和特异性强的优点。不同年龄健康人胃ＰＨ测定表明，青、老年人中位ＰＨ值，基线ＰＨ、ＰＨ〈２的百分比时间均无明显不同，老年人餐后下降期时间、进餐峰值期     

多通道阻抗联合24 h食管pH监测在胃食管反流病中的应用

目的探讨多通道阻抗联合24 h pH监测在胃食管反流病（gastroesophageal reflux disease,GERD）,尤其在pH（-）GERD患者中的应用价值。方法 48例GERD患者应用多通道阻抗联合24 h pH监测,根据Demeester评分分为pH（-）与pH（＋）,其中pH（-）GERD 30例,pH（＋）GERD 18例;另相同监测健康大学生志愿者20例做正常对照组。结果 GERD组酸反流次数、卧位食团暴露时间及总食团暴露时间均高于正常对照组,差别有统计学意义（P=0.01,P=0.002,P=0.03）;GERD组非酸反流次数低于正常对照组,差别有统计学意义（P=0.002）。pH（-）GERD组卧位食团暴露时间高于正常对照组（P=0.015）,pH（-）GERD酸反流次数及卧位食团暴露时间均低于pH（＋）GERD,差别有统计学意义（P=0.02,P=0.04）。结论多通道阻抗联合24 h pH监测能发现更多的反流事件,在GERD尤其对pH（-）GERD患者的诊断有实用意义,需进一步研究。     

The role of prolonged esophageal pH monitoring in the diagnosis of gastroesophageal reflux

To reassess 24-hour esophageal monitoring and determine if shorter time periods might retain its diagnostic benefits, we studied 16 gastroesophageal reflux (GER) patients and eight controls. Esophageal pH monitoring was performed for 24 hours, with patients in an upright position during the day and supine when retiring. During the 24-hour pH monitoring period, the mean percentage time that pH was less than 4.0 in GER patients, 13.2% +/- 2.9% (SEM), was significantly higher than in normal subjects, 0.7% +/- 0.2% (SEM). Analysis of individual data indicated clear separation of GER patients from normal subjects when in the upright posture, but 25% of GER patients were within the range of the normal subjects when supine (overnight). Three-hour time periods after meals were analyzed. Postprandial pH monitoring, when compared with 24-hour pH monitoring, can identify GER with a 77% sensitivity and a 96% specificity. A 12-hour period (four hours after the dinner meal and eight hours supine) can identify GER with a 94% sensitivity and a 100% specificity. We conclude that (1) 24-hour pH monitoring of the esophagus may have a continuing role in research aspects of GER, (2) 12-hour pH monitoring is a highly accurate test that could be adapted to patients' work schedules or to outpatient telemetry, and (3) postprandial pH testing is a practical, less expensive, and accurate method of diagnosing GER that could be utilized by any gastroenterology diagnostic unit.     

Relationship between symptom response and the esophageal pH level on standard dose of esomeprazole treatment for gastro-esophageal reflux disease

Objective To evaluate the relationship between symptom response and gastro-esophageal acidity control in Chinese gastro-esophageal reflux disease (GERD) patients on esomeprazole therapy, and to assess the role of 24-hr esophageal pH-metry after therapy in GERD patients. Methods GERD patients with typical reflux symptoms were enrolled and received esomeprazole 40 mg once daily for 4 weeks. Patients with positive baseline 24-hr esophageal pH-metry were divided into two groups depending on an additional dual-channel 24-hr pH-metry after treatment; the pH- group achieved normalization of esophageal pH level whereas the pH+ group did not. Results Of the 80 patients studied, 76 had abnormal baseline esophageal pH levels. Of these, 89.7% (52/58) of symptom-free patients and 66.7% (12/18) of symptom-persistent patients achieved esophageal pH normalization after therapy (P=0.030). The mean post-therapy gastric nocturnal % time of pH< 4 was significantly higher in pH+ group than that in pH- group (P<0.001) after therapy. The multivariate regression analysis identified hiatus hernia (P<0.001) and persistent reflux symptom (P=0.004) were 2 independent factors predicting the low post-therapy esophageal pH level. Conclusion Symptom elimination is not always accompanied by esophageal pH normalization, and vice verse. Esophageal pH-metry is recommended for GERD patients with hiatus hernia or with persistent reflux symptoms after PPI therapy.