食管pH监测对内镜阴性胃食管反流病的诊断价值探讨

目的观察食管pH监测在内镜阴性胃食管反流病中的诊断价值。方法选择临床诊断胃食管反流病（GERD）而内镜检查阴性的42例患者作为研究组，选择无上消化道症状的10例体检者作为对照组．分别行食管24h pH监测检查，分析比较其结果。结果42例内镜阴性者经食管24h pH值监测检出36例（85.71％）符合GERD诊断标准，有反流症状患者酸反流次数、酸长反流次数、最长酸反流时间、pH值〈4 总百分比、pH值〈4 立位百分比、pH值〈 4卧住百分比均显著高于正常对照组，各指标比较有统计学意义（t分别=7.95、6.38、6.12、7.34、7.86、6.06，P均〈0.05）。老年患者24h pH监测GERD栓出率显著高于非老年患者（X^2=6.36，P〈0.05）。结论食管24h pH值监测是诊断内镜检查阴性的胃食管反流病的理想方法。

Value of the esophageal pH monitoring on the diagnosis of endoscopic-negative gastro-esophageal refluxdisease

Objective To investigate the role of ambulatory esophageal pH monitoring on the diagnosis of endoscopic-negnative gastro-esophageal reflux disease （GERD）. Methods Data of consecutive forty-two patients who clinical diagnosed as GERD but negnative in endoscopic exam were analyzed with ambulatory 24hrs esophageal pH monitoring. Results 36 （85.71%） of the 42 patients were diagnosed as GERD with ambulatory 24hrs esophageal pH monitoring. The acid exposure index of the study group was significant higher than the counterpart of the control group （t=7.95, 6.38, 6.12, 7.34, 7.86, 6.06, P〈0.05）. There were more GERD in old age than young patients （X^2=6.36,P〈0.05）. Conclusions Ambulatory 24hrs esophageal pH monitoring is a good tool for the diagnosis of endoscopic-negative GERD.