24小时食管pH监测和内镜检查在胃食管反流病的诊断价值

目的:本文旨在探讨食管pH监测和内镜检查在GERD中的诊断价值。方法:临床诊断GERD患者121例行内镜及pH检查,对照组18例行内镜和pH检查。结果:内镜食管炎检出率51.2％(74/121),pH检测,阳性率87.6％(106/121)。对74例内镜诊断的食管炎与pH检测进一步分析显示食管酸暴露时间越长,内镜下炎症程度及症状越重。而32例内镜阴性的症状性反流性食管炎,症状多为轻中度,pH<4的总时间％的值亦偏低,但其数值与食管酸暴露数值有重叠。故不能以内镜阳性作为诊断GERD的客观依据,必须结合使用其他方法才能回答有否反流。结论:24h pH确实是诊断GERD的比较理想的方法。

Diagnostic Value of 24 Hour Esophageal pH Monitoring and Endoscopy in GERD

Objective: To study the diagnostic value of 24 h esophageal pH monitoring and endoscopic examination in GERD. Methods: 121 patients diagnosed as GERD according to typical clinincal symptom were investigated by endoscopy and pH monitoring. In control group 18 patients without GERD also underwent the some procedure. Results: 74 cases were detected endo-scopically as esophagitis from 121 patients with GERD (61.2 %), 106 of 131 cases (87.6 %) were also detected as GERD by pH monitoring, and no positive one in control group. Further study on the relationship of symptomes, endoscopic appearance and pH value in 74 esophagitis showed that the longer the acid exposure time of esophageal mucosa, the severer the symptom and the endoscopic inflammatory change. 32 patients with GERD of negative endoscopically had mild to moderate degree of symptoms due to overlapping with endoscopic esophagitis group so endoscopic esophagitis couldn' t be used as the criteria in diagnosing GERD, therefore combination with other methods ought to be recomended. Conclusion: 24 h pH monitoring is an accurate method to diagnose GERD.